Provider Demographics
NPI:1215231592
Name:TOPP, LUCIA ANN
Entity Type:Individual
Prefix:MRS
First Name:LUCIA
Middle Name:ANN
Last Name:TOPP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 789
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34220-0789
Mailing Address - Country:US
Mailing Address - Phone:941-722-5048
Mailing Address - Fax:941-729-8354
Practice Address - Street 1:630 79TH ST E
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:FL
Practice Address - Zip Code:34221-8891
Practice Address - Country:US
Practice Address - Phone:941-722-5048
Practice Address - Fax:941-729-8354
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-31
Last Update Date:2010-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL687827096172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL687827096OtherMEDICAID WAIVER