| Fort Pierce Center | |
|
1505 Delaware Ave Fort Pierce FL 34950-3975 | |
| (772) 461-1402 | |
| (772) 461-9972 |
| Full Name | Fort Pierce Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1505 Delaware Ave, Fort Pierce, Florida |
| Authorized Official Name and Position | Wilhelmina Lewis (PRESIDENT & CEO) |
| Authorized Official Contact | 5618449443 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fort Pierce Center 5827 Corporate Way West Palm Beach FL 33407-2000 Ph: (561) 844-9443 | Fort Pierce Center 1505 Delaware Ave Fort Pierce FL 34950-3975 Ph: (772) 461-1402 |
| NPI Number | 1104875095 |
|---|---|
| Provider Enumeration Date | 05/08/2006 |
| Last Update Date | 04/25/2019 |
| Medicare PECOS PAC ID | 9931017126 |
|---|---|
| Medicare Enrollment ID | O20100914000458 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104875095 | NPI | - | NPPES |
| 060512300 | Medicaid | FL | |
| 029574404 | Medicaid | FL |
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