Healthcare Provider Details

I. General information

NPI: 1194972851
Provider Name (Legal Business Name): ROBERT T LUTZ L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2008
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2706 ALT 19 STE 113
PALM HARBOR FL
34683-2650
US

IV. Provider business mailing address

2706 ALT 19 STE 113
PALM HARBOR FL
34683-2650
US

V. Phone/Fax

Practice location:
  • Phone: 631-232-7978
  • Fax:
Mailing address:
  • Phone: 631-232-7978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP3724
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: