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General NPI Number Information
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NPI Number | 1932333408
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Entity Type | Organization
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Legal Business Name | DIANE D LUU & ASSOCIATES
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Dates
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Enumeration Date | 05/12/2009
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Last Update Date | 05/07/2015
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Provider Practice Location Address
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Address Line | 2911 53RD AVE E
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City | BRADEN RIVER
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State | FL
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Zip | 34203-4312
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Country | US
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Telephone | 941-752-0802
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Fax | 941-752-2084
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Provider Business Mailing Address
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Address Line | PO BOX 51777
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City | SARASOTA
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State | FL
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Zip | 34232-0314
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Country | US
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Telephone | 727-453-2261
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Fax | 941-752-2084
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DIANE D LUU
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Credential | O.D.
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Telephone | 727-453-2261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 4411
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License Number State | FL
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