Provider Demographics
NPI:1043352669
Name:LUCHA, SAMUEL ELIAS (DC)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:ELIAS
Last Name:LUCHA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 LOUISIANA AVE STE D
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-4116
Mailing Address - Country:US
Mailing Address - Phone:407-593-8052
Mailing Address - Fax:407-593-9014
Practice Address - Street 1:1320 LOUISIANA AVE STE D
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-4116
Practice Address - Country:US
Practice Address - Phone:407-593-8052
Practice Address - Fax:407-593-9014
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12276111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor