Provider Demographics
NPI:1902190168
Name:LUCERNE WOMENS HEALTH SERVICES PA
Entity Type:Organization
Organization Name:LUCERNE WOMENS HEALTH SERVICES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:NARVAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-401-3816
Mailing Address - Street 1:110 S BLISS AVE
Mailing Address - Street 2:
Mailing Address - City:DUMAS
Mailing Address - State:TX
Mailing Address - Zip Code:79029-3804
Mailing Address - Country:US
Mailing Address - Phone:407-401-3816
Mailing Address - Fax:
Practice Address - Street 1:110 S BLISS AVE
Practice Address - Street 2:
Practice Address - City:DUMAS
Practice Address - State:TX
Practice Address - Zip Code:79029-3804
Practice Address - Country:US
Practice Address - Phone:407-401-3816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-06
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health