MEDICARE: DR. ANDREA L LUSK M.D.

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
1	207W00000X	Ophthalmology Physician	ME85673	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1538179270
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREA L LUSK M.D.

Provider Business Mailing Address
First Line	:	2560 GULF TO BAY BLVD
Second Line	:	STE 100
City	:	CLEARWATER
State	:	FL
Zip	:	33765-4421
Country	:	US
Telephone Number	:	727-799-3772
Fax Number	:	727-799-3772

Provider Business Practice Location Address
First Line	:	11031 US HIGHWAY 19
Second Line	:	SUITE 106
City	:	PORT RICHEY
State	:	FL
Zip	:	34668-2213
Country	:	US
Telephone Number	:	727-868-5875
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	08/16/2018

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Directions to “ DR. ANDREA L LUSK M.D.” Practice Location

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