MEDICARE: DR. WILLIAM Y LU 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	207T00000X	Neurological Surgery Physician	ME66562	FL
2	207T00000X	Neurological Surgery Physician	DR.0057976	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457300840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM Y LU M.D.

Provider Business Mailing Address
First Line	:	1605 W FAIRBANKS AVE
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32789-4603
Country	:	US
Telephone Number	:	407-975-0200
Fax Number	:	407-975-0209

Provider Business Practice Location Address
First Line	:	1600 N. GRAND AVE.
Second Line	:	STE 508
City	:	PUEBLO
State	:	CO
Zip	:	81003-2757
Country	:	US
Telephone Number	:	719-595-7040
Fax Number	:	719-595-7045

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

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	07/21/2022

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Directions to “ DR. WILLIAM Y LU M.D.” Practice Location

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