| NPI | 1518631654 |
|---|---|
| Doing Business As | ST LUCIE - PORT ST LUCIE |
| Entity Type | Organization |
| Authorized Contact | JON LEIZMAN President 216-479-9063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2021-08-03 |
| Last Update Date | 2022-08-15 |