Surgery Center of Ft Pierce LTD

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SURGERY CENTER OF FT PIERCE LTD

Practice address

1707 S 25TH St
Fort Pierce, FL 34947-4709

Phone

(772) 464-8900

Fax

(772) 464-1104

NPI assigned

Jun 12, 2006

Organization subpart

No

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

Authorized official

Name

Don Liedtke

Title

Cfo

Phone

(614) 344-5507

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Surgery Center of Ft. Pierce Doing business as

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211500800000",
    "number": "1972545291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 S 25TH ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349474709",
            "telephone_number": "772-464-8900",
            "fax_number": "772-464-1104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 S 25TH ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349474709",
            "telephone_number": "772-464-8900",
            "fax_number": "772-464-1104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY CENTER OF FT PIERCE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2008-05-23",
        "status": "A",
        "authorized_official_last_name": "LIEDTKE",
        "authorized_official_first_name": "DON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "614-344-5507"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "076161300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surgery Center of Ft. Pierce",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Fort Pierce, FL
• Providers in Fort Pierce, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.