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543 Nw Lake Whitney Pl Ste 103, Port Saint Lucie, FL 34986-1604 | |
(772) 206-0648 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Audiologist |
Location | 543 Nw Lake Whitney Pl Ste 103, Port Saint Lucie, Florida |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1265188817 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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231H00000X | Audiologist | (* (Not Available)) | Primary |
Provider Name | Lindsay Eliza Gracey |
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Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1669123865 PECOS PAC ID: 6901291954 Enrollment ID: I20220310000306 |
Mailing Address | Practice Location Address |
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543 Nw Lake Whitney Pl Ste 103, Port Saint Lucie, FL 34986-1604 Ph: (772) 206-0648 | 543 Nw Lake Whitney Pl Ste 103, Port Saint Lucie, FL 34986-1604 Ph: (772) 206-0648 |
Madison Danielle Ensley, AUD Audiologist Medicare: Medicare Enrolled Practice Location: 1801 Se Hillmoor Dr Ste B-105, Port Saint Lucie, FL 34952 Phone: 772-398-9911 |