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549 Nw Lake Whitney Pl Ste 101 Port St Lucie FL 34986-1606 | |
| (772) 732-7874 | |
| (772) 300-9093 |
| Full Name | |
|---|---|
| Speciality | Clinic/center |
| Location | 549 Nw Lake Whitney Pl Ste 101, Port St Lucie, Florida |
| Authorized Official Name and Position | Neil Bonnardel (DIRECTOR OF MEDICAL SERVICES) |
| Authorized Official Contact | 7542182164 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2304 W Oakland Park Blvd Oakland Park FL 33311-1422 Ph: (754) 218-2164 | 549 Nw Lake Whitney Pl Ste 101 Port St Lucie FL 34986-1606 Ph: (772) 732-7874 |
| NPI Number | 1003276635 |
|---|---|
| Provider Enumeration Date | 02/24/2016 |
| Last Update Date | 02/05/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003276635 | NPI | - | NPPES |
| HCC10776 | Other | FL | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Larry Quirit, M.d., P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1810 Se Port St Lucie Blvd, Port St Lucie, FL 34952 Phone: 772-398-0043 Fax: 772-398-4914 | |
Wellmed Medical Management Of Florida Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 549 Nw Lake Whitney Place, Bldg I, Suite 101, Port St Lucie, FL 34986 Phone: 210-617-4706 | |
Independent Medical Group, Llc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7436 S Federal Hwy, Port St Lucie, FL 34952 Phone: 800-773-7066 | |
The Shores Treatment And Recovery Service, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8493 S Us Highway 1, Suite 14, Port St Lucie, FL 34952 Phone: 772-800-3990 | |