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NPI Code Detail

MEDICARE: ANDREA L LUSK MD LLC

MEDICARE: ANDREA L LUSK MD LLC
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
1207W00000XOphthalmology PhysicianME 85673FL

General Provider Information

NPI Number : 1942478045
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANDREA L LUSK MD LLC
Provider Business Mailing Address
First Line : 1802 ISLEWORTH CT
Second Line :
City : OLDSMAR
State : FL
Zip : 34677-4857
Country : US
Telephone Number : 727-868-5875
Fax Number : 727-489-9494
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 : 727-489-9494
Authorized Official
Title or Position : SOLE OWNER
Name : DR. ANDREA L LUSK
Credential : MD
Telephone Number : 727-868-5875
Provider Enumeration Date : 02/12/2008
Last Update Date : 03/27/2008

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Directions to “ANDREA L LUSK MD LLC ” Practice Location

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