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General NPI Number Information
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NPI Number | 1114930633
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Entity Type | Individual
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Provider Name | JOSEPH NICHOLAS DELUCA MD, PHD
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Gender | Male
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 03/27/2017
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Provider Practice Location Address
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Address Line | 378 CENTER POINTE CIRCLE SUITE 1280
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-3442
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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 CENTER POINTE CIRCLE SUITE 1280
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-3442
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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 |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY0003384
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License Number State | FL
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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 | ME0050155
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME50155
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License Number State | FL
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