Organization · Type 2 NPI
Pediatrix Medical Group of Florida Inc
Plastic and Reconstructive Surgery Physician · Port St. Lucie, FL
NPI number
1154056109
Active
Practice location
1850 SW Fountainview Blvd Ste 201
Port St. Lucie, FL 34986-4527
Fax (855) 527-5510
Mailing address
1301 Concord Ter
Sunrise, FL 33323-2843
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Plastic Surgery Physician | 208200000X | None listed |
| Pediatric Surgery Physician | 2086S0120X | None listed |
| Plastic and Reconstructive Surgery Physician Primary | 2086S0122X | None listed |
| Pediatric Urology Physician | 2088P0231X | None listed |
Plastic and Reconstructive Surgery Physician: A surgeon who specializes in plastic and reconstructive surgery.
About NPI 1154056109
Pediatrix Medical Group of Florida Inc's National Provider Identifier is 1154056109, issued on Jul 22, 2022. The primary taxonomy on file is Plastic and Reconstructive Surgery Physician (2086S0122X), and the practice location is in Port St. Lucie, FL. The record was last updated on Oct 22, 2024.