MEDICARE: LUXUSA LLC

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	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1942549704
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUXUSA LLC

Provider Business Mailing Address
First Line	:	1334 TAMPA RD STE 118
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-5657
Country	:	US
Telephone Number	:	303-912-3424
Fax Number	:

Provider Business Practice Location Address
First Line	:	1334 TAMPA RD STE 118
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-5657
Country	:	US
Telephone Number	:	303-912-3424
Fax Number	:

Authorized Official
Title or Position	:	MANAGING DIRECTOR
Name	:	DAVID SHURTLEFF
Credential	:
Telephone Number	:	303-912-3424

Provider Enumeration Date	:	02/13/2013
Last Update Date	:	02/19/2013

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