Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | ME32853 | FL |
N | 207VG0400X | Gynecologist | ME32853 | FL |
NPI | 1164590014 |
---|---|
Provider Name | Dr. Michael John Lukowski |
First Address | Orlando, FL 32891-8025 |
Second Address | Gainesville, FL 32610-3003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2006 |
Last Update Date | 29/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01288 | BCBS (01) | FL |
065581300 | (05) | FL |
231098 | AUMGO (01) | FL |
570017 | AETNA (01) | |
D50070 | (02) |