Provider Demographics
NPI:1790552131
Name:BARELA, LUKE JAMES
Entity Type:Individual
Prefix:
First Name:LUKE
Middle Name:JAMES
Last Name:BARELA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 BRAIDWOOD LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-6912
Mailing Address - Country:US
Mailing Address - Phone:415-793-3954
Mailing Address - Fax:
Practice Address - Street 1:718 BRAIDWOOD LN
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-6912
Practice Address - Country:US
Practice Address - Phone:415-793-3954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA104070225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist