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General NPI Number Information
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NPI Number | 1154520492
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Entity Type | Organization
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Legal Business Name | LUCES REHABILITATION SERVICES INC
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Dates
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Enumeration Date | 07/17/2007
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Last Update Date | 03/14/2008
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Provider Practice Location Address
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Address Line | 8220 MENTEITH TER
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City | MIAMI LAKES
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State | FL
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Zip | 33016-1435
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Country | US
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Telephone | 305-512-8707
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Fax | 305-819-0248
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Provider Business Mailing Address
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Address Line | 8220 MENTEITH TER
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City | MIAMI LAKES
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State | FL
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Zip | 33016-1435
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Country | US
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Telephone | 305-512-8707
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Fax | 305-819-0248
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Authorized Official
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Title or Position | PRESIDENT/PHYSICAL THERAPIST
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Name | MR. RENIER J LUCES
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Credential | P.T.
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Telephone | 305-512-8707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT18649
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License Number State | FL
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