Provider Demographics
NPI:1568509644
Name:LUCES, RENIER J (PT)
Entity Type:Individual
Prefix:MR
First Name:RENIER
Middle Name:J
Last Name:LUCES
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8220 MENTEITH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1435
Mailing Address - Country:US
Mailing Address - Phone:305-512-8707
Mailing Address - Fax:305-819-0248
Practice Address - Street 1:8220 MENTEITH TER
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-1435
Practice Address - Country:US
Practice Address - Phone:305-512-8707
Practice Address - Fax:305-819-0248
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT18649225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist