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General NPI Number Information
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NPI Number | 1114220829
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Entity Type | Organization
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Legal Business Name | JOSEPH N DELUCA, PHD, PA
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Dates
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Enumeration Date | 12/20/2010
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Last Update Date | 02/03/2017
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Provider Practice Location Address
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Address Line | 378 CENTERPOINTE CIRCLE SUITE 1280
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701
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Country | US
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Telephone | 407-862-5959
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Fax | 407-774-5573
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Provider Business Mailing Address
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Address Line | 378 CENTERPOINTE CIRCLE SUITE 1280
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701
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Country | US
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Telephone | 407-862-5959
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Fax | 407-774-5573
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSEPH N. DELUCA
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Credential | MD, PHD
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Telephone | 407-862-5959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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