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General NPI Number Information
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NPI Number | 1033921655
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Entity Type | Organization
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Legal Business Name | LUCA RADOMILE NP IN PSYCHIATRY LLC
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Dates
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Enumeration Date | 01/21/2025
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 499 EVERNIA ST APT 417
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-5457
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Country | US
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Telephone | 914-732-0332
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Fax | 347-697-4825
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Provider Business Mailing Address
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Address Line | 499 EVERNIA ST APT 417
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-5457
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | LUCA RADOMILE
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Credential | PMHNP
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Telephone | 914-732-0332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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