Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist |
NPI | 1003246539 |
---|---|
Provider Name | Luceno Arce Auguis JR. |
First Address | Sunrise, FL 33323-2859 |
Second Address | Sunrise, FL 33323-2859 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2013 |
Last Update Date | 19/11/2013 |