Mark S Luedke OD PA

Primary specialty

Corporate Health Clinic/CenterTaxonomy code 261QC1800X

License

OPC2762 Issued in FL

Legal business name

MARK S LUEDKE OD PA

Practice address

9433 Balm Riverview Rd
Ste 102
Riverview, FL 33569-5120

Phone

(813) 671-2020

Fax

(813) 677-5549

NPI assigned

Oct 3, 2008

Last updated

Sep 25, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mark S Luedke, ODNPI 1316915481

Title

President

Phone

(863) 604-2020

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• Mark S Luedke, OD

  • Optometrist
  • Riverview, FL
  • NPI 1316915481
  Authorized official Same address or phone
• Carol Ann Clarkson, LDO

  • Optician
  • Riverview, FL
  • NPI 1902913890
  NPD (past)

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

{
    "created_epoch": "1222992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411603200000",
    "number": "1134370562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9433 BALM RIVERVIEW RD",
            "address_2": "STE. 102",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335695120",
            "telephone_number": "813-671-2020",
            "fax_number": "813-677-5549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9433 BALM RIVERVIEW RD",
            "address_2": "STE 102",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335695120",
            "telephone_number": "813-671-2020",
            "fax_number": "813-677-5549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK S LUEDKE OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-03",
        "last_updated": "2014-09-25",
        "status": "A",
        "authorized_official_last_name": "LUEDKE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "863-604-2020",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "261QC1800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Corporate Health",
            "state": "FL",
            "license": "OPC2762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620037100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alina Grace Manoj
• Taylor J Manu-Anno, BEHAVIOR TECHNICIAN
• Marangeli Colon, Day-by-Day Support Services
• Marangeli Colon, Day-by-Day Support Services
• Pamela Marcellin
• Olivia Mark, CNA
• Marquensy Trajean (Red Bus Pickup Non-Emergency LLC)
• Christopher James Joseph Martin, M.D.
• Cierra Ann Kathryn Martin, BEHAVIOR TECHNICIAN
• Craig Randall Martin, M.D.

• Corporate Health Clinic/Center in Riverview, FL
• Providers in Riverview, FL by specialty
• Corporate Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.