Provider Demographics
NPI:1659727543
Name:TRUNZ, LUKAS MAXIMILIAN (MD)
Entity Type:Individual
Prefix:MR
First Name:LUKAS
Middle Name:MAXIMILIAN
Last Name:TRUNZ
Suffix:
Gender:M
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:PO BOX 917368
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-0001
Mailing Address - Country:US
Mailing Address - Phone:727-441-3711
Mailing Address - Fax:
Practice Address - Street 1:300 PINELLAS ST
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3804
Practice Address - Country:US
Practice Address - Phone:727-462-7000
Practice Address - Fax:706-653-0426
Is Sole Proprietor?:No
Enumeration Date:2016-05-10
Last Update Date:2023-07-20
Deactivation Date:2017-01-05
Deactivation Code:
Reactivation Date:2017-08-02
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME1583902085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program