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General NPI Number Information
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NPI Number | 1578703237
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Entity Type | Individual
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Provider Name | DIANE L LUCAS CRNA
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Gender | Female
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Dates
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Enumeration Date | 02/20/2009
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Last Update Date | 05/29/2024
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Provider Practice Location Address
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Address Line | 4485 N STATE RD 7
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33319
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Country | US
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Telephone | 954-720-3188
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Fax | 954-586-2589
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Provider Business Mailing Address
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Address Line | 7154 N UNIVERSITY DR # 316
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City | TAMARAC
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State | FL
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Zip | 33321-2916
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Country | US
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Telephone | 954-720-3188
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Fax | 954-586-2589
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APRN1377322
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License Number State | FL
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