Kenneth H Lucas
Individual provider Active NPI Occupational Therapy Assistant · Heathrow, FL
NPI 1558649731 · NPPES record last updated Jul 22, 2011
Key facts
- NPI
- 1558649731
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- OTA 11202 (FL)
- Practice address
- 1525 International Pkwy
Heathrow, FL 32746-7644 - Phone
- (800) 798-6035
- NPI assigned
- Jul 22, 2011
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTA 11202 | FL | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OTA 11202 | FL | Yes |
Addresses
Primary practice location
1525 International Pkwy
Heathrow, FL 32746-7644
Mailing address
1525 International Pkwy
Heathrow, FL 32746-7644
Phone (800) 798-6035
Other providers in Heathrow, FL
- James Lawrence
- Leavitt Medical Associates of Florida Inc
- Lauren Leavitt
- Angela J Lee
- Donna Liegel
- Patrick Lupton
- Chad Magilke
- Robert Martinez
- April Faith Mathews
- Brian Scott Michno
All providers in Heathrow, FL · Occupational Therapy Assistant in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.