Healthcare Provider Details

I. General information

NPI: 1326647827
Provider Name (Legal Business Name): LUCAS HEARING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2020
Last Update Date: 11/09/2020
Certification Date: 11/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 E FLETCHER AVE STE 240
TAMPA FL
33613-4600
US

IV. Provider business mailing address

3450 E FLETCHER AVE STE 240
TAMPA FL
33613-4600
US

V. Phone/Fax

Practice location:
  • Phone: 813-558-1477
  • Fax:
Mailing address:
  • Phone: 813-558-1477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name: JAMES DAVID LUCAS
Title or Position: PRESIDENT
Credential:
Phone: 239-777-8576