OrganizationActive
Surgical Specialists of St Lucie
NPI 1164719209 · Ambulatory Surgical Clinic/Center · Port St Lucie, FL
Provider details
- NPI number
- 1164719209
- Entity type
- Organization
- Primary specialty
- Ambulatory Surgical Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Allen Licht, Managing Director(954) 906-9536
- License
- 1570 (FL)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(81/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
6830 S US Highway 1
Port St Lucie, FL 34952-1410
Phone: (772) 873-6700
Fax: (772) 465-5499
Street-level locationGet directions
Mailing address
12350 Nw 39th St Ste 200
Coral Springs, FL 33065-2414
Other names (DBA / former)
- Doing business as
- Blue Water Surgery Center
- Doing business as
- Blue Water Surgery Center
Registry dates
- Enumerated
- 2011-07-08
- Last updated
- 2023-06-16
- Certified
- 2023-06-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.