MEDICARE: DR. PAULA ANN DELUCA DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	PO3066	FL
2	213ES0103X	Foot & Ankle Surgery Podiatrist	PO001686	MI

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

General Provider Information

NPI Number	:	1770539090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAULA ANN DELUCA DPM

Provider Business Mailing Address
First Line	:	10075 JOG ROAD
Second Line	:	STE 208
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437
Country	:	US
Telephone Number	:	561-734-4867
Fax Number	:

Provider Business Practice Location Address
First Line	:	10075 S JOG RD
Second Line	:	STE 208
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-3535
Country	:	US
Telephone Number	:	561-734-4867
Fax Number	:

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

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	04/05/2013

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