TREASURE COAST NEUROLOGY WEST, LLC
Ambulatory Health at Saint Lucie Blvd, Fort Pierce, FL

License number
Florida ARNP 3283142
Category
Ambulatory Health
Type
Multi-Specialty
Owner
Name: LUCILLE ANN VANDEVERE ARNP
Title: OWNER
Phone: (772) 873-1005
Address
Address 2
1420 SW Saint Lucie Blvd WEST SUITE 102, Fort Pierce, FL 34986
PO Box 881565, Port Saint Lucie, FL 34988
National Provider ID: 1619921301
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about TREASURE COAST NEUROLOGY WEST, LLC at bizstanding.com

Treasure Coast Neurology West, LLC

Fort Pierce, FL

Status:
Inactive
Registration:
Mar 24, 2006
Addresses:
1420 SW Saint Lucie West Blvd, Fort Pierce, FL 34986
PO Box 881565, Fort Pierce, FL 34988
State ID:
L06000031218
Business type:
Florida Limited Liability
Managers:
Ginger Kopenski Manager, inactive,Lucille Vandevere Manager, inactive

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