MEDICARE: EMILY ANN LUCIUS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist
2	225XH1200X	Hand Occupational Therapist	1071100205	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	OT10286	OTHER	FL	STATE OF FLORIDA DEPARTMENT OF HEALTH

General Provider Information

NPI Number	:	1184739096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY ANN LUCIUS

Provider Business Mailing Address
First Line	:	13020 N TELECOM PKWY
Second Line	:
City	:	TEMPLE TERRACE
State	:	FL
Zip	:	33637-0915
Country	:	US
Telephone Number	:	813-978-9700
Fax Number	:	813-558-6185

Provider Business Practice Location Address
First Line	:	2653 BRUCE B DOWNS BLVD STE 201
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33544-9206
Country	:	US
Telephone Number	:	813-978-9700
Fax Number	:	813-558-6185

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	07/13/2023

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Directions to “ EMILY ANN LUCIUS ” Practice Location

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