Provider Demographics
NPI:1235785676
Name:EL-AMIN-LUCAS, NADIYAH
Entity Type:Individual
Prefix:
First Name:NADIYAH
Middle Name:
Last Name:EL-AMIN-LUCAS
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 1:2912 E 23RD AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33605-2122
Mailing Address - Country:US
Mailing Address - Phone:813-373-5165
Mailing Address - Fax:
Practice Address - Street 1:2912 E 23RD AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33605-2122
Practice Address - Country:US
Practice Address - Phone:813-298-3162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-12
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health