Healthcare Provider Details

I. General information

NPI: 1760062038
Provider Name (Legal Business Name): DONNA LUKE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2021
Last Update Date: 09/21/2023
Certification Date: 09/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 JFK DR
ATLANTIS FL
33462-6608
US

IV. Provider business mailing address

140 JFK DR
ATLANTIS FL
33462-6608
US

V. Phone/Fax

Practice location:
  • Phone: 561-968-6767
  • Fax:
Mailing address:
  • Phone: 561-968-6767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number03210700
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: