Provider Demographics
NPI:1114416740
Name:LUTCHMIDAT, DEVIKA B (FNP)
Entity Type:Individual
Prefix:MRS
First Name:DEVIKA
Middle Name:B
Last Name:LUTCHMIDAT
Suffix:
Gender:F
Credentials:FNP
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Mailing Address - Street 1:1204 STONE HARBOUR RD
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-4738
Mailing Address - Country:US
Mailing Address - Phone:407-615-0563
Mailing Address - Fax:407-542-8059
Practice Address - Street 1:11954 NARCOOSSEE RD STE 2-167
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-6998
Practice Address - Country:US
Practice Address - Phone:407-335-3549
Practice Address - Fax:866-366-6603
Is Sole Proprietor?:No
Enumeration Date:2018-05-09
Last Update Date:2024-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP9332051363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily