Healthcare Provider Details

I. General information

NPI: 1699681692
Provider Name (Legal Business Name): LUCAS MIGLIAZZA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1019 KANE CONCOURSE STE 101
BAY HARBOR ISLANDS FL
33154-2137
US

IV. Provider business mailing address

1019 KANE CONCOURSE STE 101
BAY HARBOR ISLANDS FL
33154-2137
US

V. Phone/Fax

Practice location:
  • Phone: 305-984-1155
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number16106
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: