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General NPI Number Information
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NPI Number | 1063704898
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Entity Type | Individual
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Provider Name | ZACHARY LEE LUKOWSKI M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/12/2011
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 1600 SW ARCHER RD
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City | GAINESVILLE
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State | FL
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Zip | 32610-3091
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Country | US
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Telephone | 352-265-0301
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 100284
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City | GAINESVILLE
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State | FL
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Zip | 32610-0284
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Country | US
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Telephone | 352-273-8778
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Fax | 352-273-7402
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 078790
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | 078790
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME124130
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License Number State | FL
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