Provider Demographics
NPI:1659122299
Name:LUCAS, ANA PAULA (MD)
Entity Type:Individual
Prefix:
First Name:ANA PAULA
Middle Name:
Last Name:LUCAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE PORO, CONDOMINIO VISTAS DE SAN RAFAEL
Mailing Address - Street 2:APT # 2
Mailing Address - City:SAN JOSE
Mailing Address - State:ESCAZU
Mailing Address - Zip Code:10203
Mailing Address - Country:CR
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:703 N FLAMINGO RD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1006
Practice Address - Country:US
Practice Address - Phone:954-844-4491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-01
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program