PHYSICIANS IMMEDIATE CARE ST LUCIE WEST, LLC
Ambulatory Health at Saint Lucie Blvd, Fort Pierce, FL

License number
Florida HCC8077
Category
Ambulatory Health
Type
Urgent Care
Owner
Name: KENNETH PALESTRANT M.D.
Title: CEO
Phone: (772) 343-1776
Address
Address
1730 SW Saint Lucie Blvd WEST, Fort Pierce, FL 34986
National Provider ID: 1699160952
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PHYSICIANS IMMEDIATE CARE ST LUCIE WEST, LLC

Fort Pierce, FL

Registration:
Jun 11, 2013
Addresses:
1730 SW St Lucie Blvd, Port Saint Lucie, FL 34986 (Physical)
1730 SW Saint Lucie West Blvd, Fort Pierce, FL 34986
State ID:
L13000084055
Business type:
Florida Limited Liability Company
Managing Members:
Kenneth J Palestrant (Managing Member), 4007 SW Prt St Lucie Blvd, Port Saint Lucie, FL 34953 (Physical),Gabriella Palestrant (Managing Member), 2012 SE Kilmallie Ct, Port Saint Lucie, FL 34952 (Physical),Physicians Immediate Care Group, Llc Managing Member, inactive
Agent:
Reittinger & Associates,4520 Dixie Hwy NE, Palm Bay, FL 32905 (Physical)
EIN:
46-2967621

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