Provider Demographics
NPI:1619030731
Name:MICHAEL J LUKOWSKI & ASSOCIATES
Entity Type:Organization
Organization Name:MICHAEL J LUKOWSKI & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:LUKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-333-0033
Mailing Address - Street 1:6640 W NEWBERRY RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4369
Mailing Address - Country:US
Mailing Address - Phone:352-333-0033
Mailing Address - Fax:352-332-3935
Practice Address - Street 1:6640 W NEWBERRY RD SUITE 201
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4369
Practice Address - Country:US
Practice Address - Phone:352-333-0033
Practice Address - Fax:352-332-3935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME32853207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL01228AMedicare ID - Type Unspecified