Healthcare Provider Details

I. General information

NPI: 1336185420
Provider Name (Legal Business Name): IVO W TREMONT-LUKATS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 N ORANGE AVE STE 286
ORLANDO FL
32804-4675
US

IV. Provider business mailing address

2501 N ORANGE AVE STE 286
ORLANDO FL
32804-4675
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-2770
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number199976
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME171481
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: