Port St Lucie Medical Wellness

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

PORT ST LUCIE MEDICAL WELLNESS

Practice address

702 SW Port St Lucie Blvd
Port Saint Lucie, FL 34953-2617

Phone

(772) 207-0080

NPI assigned

Aug 22, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Harsha Setty, MD

Title

Medical Director

Phone

(813) 629-6203

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1724284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724284800000",
    "number": "1821821067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SW PORT ST LUCIE BLVD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349532617",
            "telephone_number": "772-207-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 SW PORT ST LUCIE BLVD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349532617",
            "telephone_number": "772-207-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORT ST LUCIE MEDICAL WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-22",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A",
        "authorized_official_last_name": "SETTY",
        "authorized_official_first_name": "HARSHA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "813-629-6203",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lorianne Marie Poling, PHARM.D
• Sarah Michelle Pomerantz
• Jorge Ponce
• Sabrina Cathleen Pope, PTA, LMT,NCTM
• Port Saint Lucie Imaging LLC
• Port St. Lucie MGT LLC
• Winsome Powell
• Omar Poyo
• Silvia Esther Pozo
• Maria Defatima Pozuelo, MD

• Primary Care Nurse Practitioner in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Primary Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; 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.