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General NPI Number Information
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NPI Number | 1306582051
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Entity Type | Individual
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Provider Name | HENRY LUCATE
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Gender | Male
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Dates
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Enumeration Date | 05/06/2022
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Last Update Date | 07/05/2022
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Provider Practice Location Address
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Address Line | 3200 S. HIAWASSEE RD SUITE 203 ROOM 1230
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City | ORLANDO
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State | FL
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Zip | 32835
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Country | US
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Telephone | 321-974-4039
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Fax |
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Provider Business Mailing Address
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Address Line | 5912 JASON ST
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City | ORLANDO
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State | FL
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Zip | 32809-5015
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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 |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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