TREASURE COAST NEUROLOGY WEST, LLC (NPI# 1619921301) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619921301 |
| Entity Type | Organization |
| Organization Name | TREASURE COAST NEUROLOGY WEST, LLC |
| Practice Address |
1420 Sw Saint Lucie West Blvd Suite 102 Port St Lucie FL 34986-1709 |
| Mailing Address |
Po Box 881565 Port St Lucie FL 34988-1565 |
| Practice Telephone | 7728731005 |
| Practice Fax Number | 7725959986 |
| Mailing Telephone | 7728731005 |
| Mailing Fax Number | 7725959986 |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | LUCILLE ANN VANDEVERE (OWNER) |
| Authorized Official Telephone | 7728731005 |
| Authorized Official Credential | ARNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
ARNP 3283142 | FL | Ambulatory Health Care Facilities |
| Street Address |
1420 SW SAINT LUCIE WEST BLVD SUITE 102 |
| City | PORT ST LUCIE |
| State | FL |
| Zip Code | 34986-1709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366744997 | Agustin C Sanz Md Pa | Specialist | 1420 Sw Saint Lucie West Blvd, Port St Lucie, FL 34986-1709 | 2010-12-02 |
| 1447364534 | Patrick M. Gonzalez | Physical Medicine & Rehabilitation | 1420 Sw Saint Lucie West Blvd, Suite 102, Port St Lucie, FL 34986-1709 | 2006-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962992933 | Lindsay B Rojas | Occupational Therapist | 827 Sw Grand Reserves Blvd, Port St Lucie, FL 34986 | 2018-05-15 |
| 1639685266 | Natoya A Queenbourrows | Family Medicine | 2145 Nw Padova St, Port St Lucie, FL 34986 | 2017-12-19 |
| 1740634930 | The Toledo Clinic, LLC | Clinic/Center | 5481 Nw East Torino Parkway, Port St. Lucie, FL 34986 | 2016-04-14 |
| 1326407230 | Merline Smellie | Social Worker | 525 Nw Lake Whitney Place, Ste 102 & 103, Port St Lucie, FL 34986 | 2016-02-19 |
| 1124486949 | Therapy Connection of The Treasure Coast | Speech-Language Pathologist | 549 Nw Lake Whitney Pl Ste 104, Port St Lucie, FL 34986 | 2016-02-08 |
| 1689050015 | Yudelquis Comas Sanchez | Internal Medicine | Lawnwood Regional Medical Center, 1700 S 23rd St, Fort Pierce, FL 34986 | 2015-08-07 |
| 1689056889 | Joshua Chupp | Dentist | 1384 Sw St. Lucie West Blvd, Port St. Lucie, FL 34986 | 2015-06-24 |
| 1366821720 | Kids Therapy Solutions | Occupational Therapist | 161 Sw Palm Dr # 201, Port St Lucie, FL 34986 | 2015-05-19 |
| 1134514086 | Comfortable Care Dental Health Professionals, Pa | Dentist | 1384 Sw St. Lucie, Port St. Lucie, FL 34986 | 2015-03-30 |
| 1750787586 | Timothy Michael Kennedy | Chiropractor | 1680 Sw Saint Lucie West Blvd Ste 204, Port St Lucie, FL 34986 | 2014-11-05 |
| Find all providers in zip 34986 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083074835 | The Shores Treatment and Recovery Service, LLC | Clinic/Center | 8493 S Us Highway 1, Suite 14, Port St Lucie, FL 34952-3360 | 2016-03-07 |
| 1215975263 | Accurate Pain & Rehab Center | Clinic/Center | 1701 Se Hillmoor Dr, Ste. #a-1, Port St Lucie, FL 34952-7552 | 2006-06-03 |
| 1275582173 | Heart and Family Health Institute of Port St Lucie | Clinic/Center | 1700 Se Hillmoor Dr, Suite 200, Port St Lucie, FL 34952-7539 | 2006-05-08 |
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| 1932718509 | Coral Diagnostic Center Inc | Clinic/Center | 12002 Sw 128th Ct Ste 202, Miami, FL 33186-4643 | 2020-07-29 |
| 1902422215 | Andreu Health Care Therapy Corp | Clinic/Center | 175 Fontainebleau Blvd Ste 2g7, Miami, FL 33172-7012 | 2020-06-23 |
| 1306461447 | Elevate Medical Fort Myers, LLC | Clinic/Center | 1850 Boy Scout Dr Ste A102, Fort Myers, FL 33907-2127 | 2020-06-15 |
| 1629699889 | Comprehensive Cardiovascular Institute, Pllc | Clinic/Center | 17 Davis Blvd Ste 313, Tampa, FL 33606-3438 | 2020-04-29 |
| Find all providers with the same taxonomy | ||||
| City | PORT ST LUCIE |
| Zip Code | 34986 |
Please comment or provide details below to improve the information on TREASURE COAST NEUROLOGY WEST, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.