Organization Active NPI

Lucha Chiropractic Quality Center LLC

  • Chiropractor
  • Saint Cloud, FL
National Provider Identifier
1093311854
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
LUCHA CHIROPRACTIC QUALITY CENTER LLC
Practice address
1320 Louisiana Ave Ste D
Saint Cloud, FL 34769-4116
Phone
(407) 593-8052
Fax
(407) 593-9014
NPI assigned
Dec 8, 2020
Last updated
Dec 8, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Samuel Elias Lucha, DCNPI 1043352669
Title
Chiropractor
Phone
(407) 593-8052

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X Primary

Addresses

Primary practice location

1320 Louisiana Ave Ste D
Saint Cloud, FL 34769-4116

Mailing address

1320 Louisiana Ave Ste D
Saint Cloud, FL 34769-4116
Phone (407) 593-8052

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL luchachiropractic@gmail.com Lucha Chiropractic Quality Center

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210427002641 FL Part B Supplier - Clinic/Group Practice 8820406036 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Cloud, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1607385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607385600000",
    "number": "1093311854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 LOUISIANA AVE STE D",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347694116",
            "telephone_number": "407-593-8052",
            "fax_number": "407-593-9014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 LOUISIANA AVE STE D",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347694116",
            "telephone_number": "407-593-8052",
            "fax_number": "407-593-9014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCHA CHIROPRACTIC QUALITY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-08",
        "last_updated": "2020-12-08",
        "certification_date": "2020-11-25",
        "status": "A",
        "authorized_official_last_name": "LUCHA",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "ELIAS",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "407-593-8052",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "luchachiropractic@gmail.com",
            "affiliation": "Y",
            "affiliationName": "Lucha Chiropractic Quality Center",
            "address_1": "1320 Louisiana Ave Ste D",
            "city": "Saint Cloud",
            "state": "FL",
            "country_code": "US",
            "postal_code": "347694116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Cloud, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.