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General NPI Number Information
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NPI Number | 1003618406
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Entity Type | Organization
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Legal Business Name | FLORIDA COAST MEDICAL AND SURGICAL CENTER, INC.
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Dates
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Enumeration Date | 03/26/2025
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 310 SE VERANDA FALLS WAY
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City | PORT ST LUCIE
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State | FL
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Zip | 34984-2101
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Country | US
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Telephone | 772-309-8500
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Fax | 772-607-5256
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Provider Business Mailing Address
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Address Line | PO BOX 591
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City | CHESTERTON
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State | IN
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Zip | 46304-0591
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Country | US
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Telephone | 772-309-8500
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Fax | 772-607-5256
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Authorized Official
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Title or Position | CFO
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Name | MR. LUCAS IWANSKI
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Credential |
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Telephone | 772-309-8604
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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