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1701 Hillmoor Ave Ste 19 Port St. Luce FL 34952-7552 | |
(772) 337-4000 | |
(561) 844-1013 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 1701 Hillmoor Ave, Port St. Luce, Florida |
Authorized Official Name and Position | Wilhelmina N. Lewis (CEO & PRESIDENT) |
Authorized Official Contact | 5618449443 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5827 Corporate Way West Palm Beach FL 33407-2000 Ph: (561) 844-9443 | 1701 Hillmoor Ave Ste 19 Port St. Luce FL 34952-7552 Ph: (772) 337-4000 |
NPI Number | 1407421597 |
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Provider Enumeration Date | 05/21/2021 |
Last Update Date | 06/18/2021 |
Identifier | Type | State | Issuer |
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1407421597 | NPI | - | NPPES |