OrganizationActive
2096 East Ocean Boulevard, Lc
NPI 1609940899 · Ambulatory Surgical Clinic/Center · Stuart, FL
Provider details
- NPI number
- 1609940899
- Entity type
- Organization
- Primary specialty
- Ambulatory Surgical Clinic/CenterAmbulatory Health Care Facilities
- Authorized official
- Barbara Tidwell, Administrator
- License
- 901 (FL)
Practice location
2096 Se Ocean Blvd
Stuart, FL 34996-3304
Phone: (772) 223-0174
Fax: (772) 223-0558
Mailing address
2096 Se Ocean Blvd
Stuart, FL 34996-3304
Registry dates
- Enumerated
- 2006-11-20
- Last updated
- 2012-02-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.