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General NPI Number Information
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NPI Number | 1265393847
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Entity Type | Organization
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Legal Business Name | LUCET AT HOME OF FLORIDA PA
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Dates
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Enumeration Date | 11/21/2025
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 4800 DEERWOOD CAMPUS PKWY BUILDING 400, SUITE DCC4-1-002
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City | JACKSONVILLE
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State | FL
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Zip | 32246-8317
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Country | US
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Telephone | 877-887-1797
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Fax |
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Provider Business Mailing Address
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Address Line | 6100 SPRINT PKWY STE 200
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City | OVERLAND PARK
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State | KS
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Zip | 66211-1196
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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 | PRESIDENT/CEO
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Name | SEAN MARTIN
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Credential | MD
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Telephone | 636-409-8110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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