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General NPI Number Information
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NPI Number | 1699955328
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Entity Type | Organization
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Legal Business Name | LOUIS DELUCA MD PA
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Dates
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Enumeration Date | 11/09/2007
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Last Update Date | 09/07/2011
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Provider Practice Location Address
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Address Line | 1905 CLINT MOORE RD SUITE 303
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City | BOCA RATON
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State | FL
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Zip | 33496-2658
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Country | US
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Telephone | 561-998-3333
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Fax | 561-353-1583
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Provider Business Mailing Address
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Address Line | 1905 CLINT MOORE RD SUITE 303
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City | BOCA RATON
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State | FL
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Zip | 33496-2658
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Country | US
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Telephone | 561-998-3333
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Fax | 561-353-1583
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Authorized Official
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Title or Position | OWNER
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Name | DR. LOUIS S DELUCA
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Credential | M.D.
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Telephone | 561-998-3333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number |
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License Number State |
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