Healthcare Provider Details

I. General information

NPI: 1245151018
Provider Name (Legal Business Name): LUCA FAMILY MEDICAL CENTER CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1414 NW 107TH AVE STE 310
SWEETWATER FL
33172-2742
US

IV. Provider business mailing address

1414 NW 107TH AVE STE 310
SWEETWATER FL
33172-2742
US

V. Phone/Fax

Practice location:
  • Phone: 305-632-8462
  • Fax:
Mailing address:
  • Phone: 305-632-8462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: HEIDY RIZO
Title or Position: PRESIDENT
Credential: OWNER
Phone: 305-632-8462