Healthcare Provider Details

I. General information

NPI: 1255331187
Provider Name (Legal Business Name): MARTIN COUNTY FLORIDA BOARD OF COMMISSIONERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 04/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 SE MONTEREY RD
STUART FL
34994-4507
US

IV. Provider business mailing address

3485 SE WILLOUGHBY BLVD
STUART FL
34994-5060
US

V. Phone/Fax

Practice location:
  • Phone: 772-288-5710
  • Fax: 772-288-5942
Mailing address:
  • Phone: 772-463-7277
  • Fax: 772-419-4544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number001740
License Number StateFL

VIII. Authorized Official

Name: MRS. LYNN MOORE
Title or Position: EMS BILLING MANAGER
Credential:
Phone: 772-463-6277