| South Palm Family Center | |
|
1701 Se Hillmoor Dr Ste B9 Port Saint Lucie FL 34952-7540 | |
| (772) 348-0303 | |
| Not Available |
| Full Name | South Palm Family Center |
|---|---|
| Speciality | Family Medicine |
| Location | 1701 Se Hillmoor Dr Ste B9, Port Saint Lucie, Florida |
| Authorized Official Name and Position | Judith C Brooks (MANAGER) |
| Authorized Official Contact | 7723480303 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Palm Family Center 1701 Se Hillmoor Dr Ste B9 Port Saint Lucie FL 34952-7540 Ph: (772) 348-0303 | South Palm Family Center 1701 Se Hillmoor Dr Ste B9 Port Saint Lucie FL 34952-7540 Ph: (772) 348-0303 |
| NPI Number | 1720746951 |
|---|---|
| Provider Enumeration Date | 12/06/2021 |
| Last Update Date | 09/06/2023 |
| Medicare PECOS PAC ID | 0244623353 |
|---|---|
| Medicare Enrollment ID | O20220214002167 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720746951 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Judith C Brooks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235398025 PECOS PAC ID: 2466690649 Enrollment ID: I20130529000724 |
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