Organization
PORT ST LUCIE SURGERY CENTER LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM GREGORY SWINNEY (VP)
(972) 789-2877
Entity
Organization
Contact information
Practice address
1310 SE WEST STAR AVE, PORT ST LUCIE, FL 34952-7557
(772) 337-5200
(772) 337-7955
Mailing address
1310 SE WEST STAR AVE, PORT ST LUCIE, FL 34952-7557
(772) 337-5200
(772) 337-7955
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1040
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
079224100
—
FL
Enumeration date
04/17/2006
Last updated
02/13/2018
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