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NPI Code Detail

MEDICARE: ST. LUCIE ANESTHESIA ASSOCIATES, LLC

MEDICARE: ST. LUCIE ANESTHESIA ASSOCIATES, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669044384
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST. LUCIE ANESTHESIA ASSOCIATES, LLC
Provider Business Mailing Address
First Line : PO BOX 745923
Second Line :
City : ATLANTA
State : GA
Zip : 30374-5923
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3602 KYOTO GARDENS DR
Second Line :
City : PALM BEACH GARDENS
State : FL
Zip : 33410-2713
Country : US
Telephone Number : 877-328-1119
Fax Number :
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : CHRISTOPHER KENNEDY
Credential :
Telephone Number : 207-807-9008
Provider Enumeration Date : 07/13/2021
Last Update Date : 08/06/2025

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