NPIMap

Organization Active NPI

St Lucie General Surgery LLC

  • Surgery Physician
  • Port St Lucie, FL
National Provider Identifier
1922180249
Registry record updated Aug 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
ST LUCIE GENERAL SURGERY LLC
Practice address
1700 SE Hillmoor Dr
Suite 503
Port St Lucie, FL 34952-7539
Phone
(772) 335-7606
NPI assigned
Oct 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2007

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

Authorized official

Name
Mickey Pickler
Title
VP
Phone
(772) 335-7606

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

1700 SE Hillmoor Dr
Suite 503
Port St Lucie, FL 34952-7539

Mailing address

1700 SE Hillmoor Dr
Suite 503
Port St Lucie, FL 34952-7539
Phone (772) 335-7606

National Provider Directory

National Provider Directory

Locations

1700 SE Hillmoor Dr
Ste 503
Port St Lucie, FL 34952
Phone 56139889998

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188172800000",
    "number": "1922180249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 SE HILLMOOR DR",
            "address_2": "SUITE 503",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527539",
            "telephone_number": "772-335-7606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 SE HILLMOOR DR",
            "address_2": "SUITE 503",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527539",
            "telephone_number": "772-335-7606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUCIE GENERAL SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-08-27",
        "status": "A",
        "authorized_official_last_name": "PICKLER",
        "authorized_official_first_name": "MICKEY",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "772-335-7606"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2007; 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.