Luke Christian Detlor

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-19-83433 Issued in FL

Practice address

11820 Denton Ave
Hudson, FL 34667-5419

Phone

(727) 862-9101

NPI assigned

May 22, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Therhappy Therapy Services, Inc.

  • Physical Therapist
  • Hudson, FL
  • NPI 1023361987
  NPD (past)
• Therhappy Therapy Services, Inc.

  • Contractor
  • Hudson, FL
  • NPI 1750242350
  NPD (past)

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

{
    "created_epoch": "1558483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558483200000",
    "number": "1861059156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12804 PECAN TREE DR",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346692849",
            "telephone_number": "727-255-9995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11820 DENTON AVE",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346675419",
            "telephone_number": "727-862-9101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETLOR",
        "first_name": "LUKE",
        "middle_name": "CHRISTIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-22",
        "last_updated": "2019-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-19-83433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "751940",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mindy Lynn Decker, RPHT
• Kenneth Mark Degraaf, MD
• Jacqueline Anne Deloof
• Justin Deptula, D.O.
• Marshall Matthew Desantis, MD
• Dana M Deupree, MD
• Anthony Sam Di Cecca, DO
• Peter Louis Di Martino, MD
• Diabetes Care Center, Inc.
• Diabetes Thyroid and Endocrinology Center PL

• Behavior Technician in Hudson, FL
• Providers in Hudson, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; 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.