NPIMap

Organization Active NPI

Saint Lucie Pediatrics Inc

  • Pediatrics Physician
  • Fort Pierce, FL
National Provider Identifier
1710032875
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
SAINT LUCIE PEDIATRICS INC
Practice address
2011 S 25TH St Ste 105
Fort Pierce, FL 34947-4795
Phone
(772) 460-8235
Fax
(772) 460-5010
NPI assigned
Jan 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Authorized official

Name
Dr. Raul Rodriguez-Torres, M.D.
Title
C.E.O.
Phone
(772) 460-8235

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

2011 S 25TH St Ste 105
Fort Pierce, FL 34947-4795

Mailing address

2011 S 25TH St Ste 105
Fort Pierce, FL 34947-4795
Phone (772) 460-8235

Other identifiers 1

IdentifierTypeStateIssuer
263456200MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Saint Lucie Pediatrics Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1710032875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 S 25TH ST STE 105",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349474795",
            "telephone_number": "772-460-8235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 S 25TH ST STE 105",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349474795",
            "telephone_number": "772-460-8235",
            "fax_number": "772-460-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT LUCIE PEDIATRICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ-TORRES",
        "authorized_official_first_name": "RAUL",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "772-460-8235",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263456200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.