Luckner Isme I

Primary specialty

DriverTaxonomy code 172A00000X

License

I250520832670 Issued in FL

Practice address

26736 Saville Ave
Bonita Springs, FL 34135-6339

Phone

(239) 213-8179

NPI assigned

Apr 4, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1680566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1619672011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26736 SAVILLE AVE",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341356339",
            "telephone_number": "239-213-8179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26736 SAVILLE AVE",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341356339",
            "telephone_number": "239-213-8179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISME",
        "first_name": "LUCKNER",
        "name_suffix": "I",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-04",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "FL",
            "license": "I250520832670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integrated Medical Centre of Bonita Springs Inc
• Integrated Pain Solutions of Florida, PLLC
• Intercellular Sciences, LLC
• Interventional Rehabilitation of South Florida, Inc.
• Elena Theresa Ippolito
• IV Drug Solutions
• J-M Ward Enterprises LLC
• J&JL Enterprises, LLC D/B/a J&J Louis Enterprises, LLC (John'S Pharmac
• Albert Kenneth Jabbour, PA
• Scott H Jaffe, M.D

• Driver in Bonita Springs, FL
• Providers in Bonita Springs, FL by specialty
• Driver in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; 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.