Provider Demographics
NPI:1811423718
Name:LUZENSKI, DAVID JOSEPH JR (MS, ATC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JOSEPH
Last Name:LUZENSKI
Suffix:JR
Gender:M
Credentials:MS, ATC
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:3301 COLLEGE AVE
Mailing Address - Street 2:DEPARTMENT OF ATHLETICS
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-7721
Mailing Address - Country:US
Mailing Address - Phone:954-262-8224
Mailing Address - Fax:
Practice Address - Street 1:3301 COLLEGE AVE
Practice Address - Street 2:DEPARTMENT OF ATHLETICS
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-7721
Practice Address - Country:US
Practice Address - Phone:954-262-8224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL 48122255A2300X
GAAT0021382255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer