MEDICARE: DR. VINH DUC LUU M.D.

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	207RC0000X	Cardiovascular Disease Physician	48198	WA
2	207RC0000X	Cardiovascular Disease Physician	14025	HI
3	207RC0000X	Cardiovascular Disease Physician	27181	OR
4	207RC0000X	Cardiovascular Disease Physician	ME112813	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	GG060Z	OTHER	FL	MEDICARE PTAN
2	P00732012	OTHER	WA	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1194715607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VINH DUC LUU M.D.

Provider Business Mailing Address
First Line	:	8340 COLLIER BLVD STE 202
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34114-3589
Country	:	US
Telephone Number	:	393-484-2212
Fax Number	:	239-354-6588

Provider Business Practice Location Address
First Line	:	8340 COLLIER BLVD STE 202
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34114
Country	:	US
Telephone Number	:	239-348-4221
Fax Number	:	239-354-6588

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

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	09/10/2020

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