Provider Demographics
NPI:1891275962
Name:LUCCHESI, JOSEPH ESIO (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ESIO
Last Name:LUCCHESI
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12241 LONDONDERRY LN
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-6369
Mailing Address - Country:US
Mailing Address - Phone:847-361-0777
Mailing Address - Fax:
Practice Address - Street 1:6804 PORTO FINO CIR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-7139
Practice Address - Country:US
Practice Address - Phone:239-362-1485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-18
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT33946261QP2000X, 2251X0800X
FLPT339642251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty