Healthcare Provider Details

I. General information

NPI: 1912893405
Provider Name (Legal Business Name): MISHEL PAULETTE LUZURIAGA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2025
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 SW ARCHER RD
GAINESVILLE FL
32608-1135
US

IV. Provider business mailing address

1601 SW ARCHER RD FL 32608
GAINESVILLE FL
32608-1135
US

V. Phone/Fax

Practice location:
  • Phone: 786-223-9407
  • Fax:
Mailing address:
  • Phone: 786-223-9407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW23209
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: