| |
8881 Sw Montova Way, Port St Lucie, FL 34987-8708 | |
(772) 275-5549 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Clinic/center |
Location | 8881 Sw Montova Way, Port St Lucie, Florida |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1174022859 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225X00000X | Occupational Therapist | OT18631 (Florida) | Secondary |
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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8881 Sw Montova Way, Port Saint Lucie, FL 34987-8708 Ph: (772) 521-5238 | 8881 Sw Montova Way, Port St Lucie, FL 34987-8708 Ph: (772) 275-5549 |