Healthcare Provider Details

I. General information

NPI: 1164362018
Provider Name (Legal Business Name): MRS. GILDA LUSCAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1628 LEDGESTONE DR
BRANDON FL
33511-8332
US

IV. Provider business mailing address

1628 LEDGESTONE DR
BRANDON FL
33511-8332
US

V. Phone/Fax

Practice location:
  • Phone: 407-334-1410
  • Fax:
Mailing address:
  • Phone: 407-334-1410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF03260902
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: