Individual provider Active NPI

Mackendy Fleuridor, PA

  • Surgical Assistant
  • Port Saint Lucie, FL
National Provider Identifier
1699427476
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
Practice address
5334 NW Alam Cir
Port Saint Lucie, FL 34986-3531
Phone
(813) 507-2978
NPI assigned
Jan 22, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 246ZC0007X Primary

Addresses

Primary practice location

5334 NW Alam Cir
Port Saint Lucie, FL 34986-3531

Mailing address

5334 NW Alam Cir
Port Saint Lucie, FL 34986-3531

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1642809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1699427476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5334 NW ALAM CIR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349863531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5334 NW ALAM CIR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349863531",
            "telephone_number": "813-507-2978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEURIDOR",
        "first_name": "MACKENDY",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-22",
        "last_updated": "2025-09-11",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.