Provider Demographics
NPI:1255941407
Name:TREASURE COAST HEALTH
Entity type:Organization
Organization Name:TREASURE COAST HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAMERON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-261-9909
Mailing Address - Street 1:1100 SW SAINT LUCIE WEST BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-1780
Mailing Address - Country:US
Mailing Address - Phone:772-800-3037
Mailing Address - Fax:772-807-1409
Practice Address - Street 1:1100 SW SAINT LUCIE WEST BLVD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-1780
Practice Address - Country:US
Practice Address - Phone:772-800-3037
Practice Address - Fax:772-807-1409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-03
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty