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W.D.LUCKY M.D. INC NPI 1396772224


NPI Information

NPI: 1396772224
Provider Name: W.D.LUCKY, M.D., INC

Other Name: W.D. LUCKY, M.D., INC

Classification: Specialist - 174400000X
Entity Type: Organization
Address:
13520 SW 152ND ST
#771834
MIAMI, FL
ZIP 33177
Phone: (305) 238-3990
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W.D.LUCKY, M.D., INC is a specialist in Miami, FL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. W.D.LUCKY, M.D., INC NPI is 1396772224. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is W.d. Lucky, M.d., Inc.

The provider's business location address is:

13520 SW 152ND ST
#771834
MIAMI, FL
ZIP 33177-031
Phone: (305) 238-3990

The provider's authorized official is William David Lucky .
The authorized official title is President and has the following contact phone number (305) 238-3990.

The enumeration date for this NPI number is 6/27/2006 and was last updated on 1/5/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialist0029049FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
15CU88MEDICARE PINLOUISIANA
2K5918MEDICARE ID-TYPE UNSPECIFIEDFLORIDA
3K5918CMEDICARE PINFLORIDA
4038136500MEDICAIDFLORIDA
595193YOTHERFLORIDAFL MEDICARE INDIVIDUAL PTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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