Provider Demographics
NPI:1952052284
Name:SANLUCAS, ROBERTO FRANCISCO
Entity Type:Individual
Prefix:
First Name:ROBERTO
Middle Name:FRANCISCO
Last Name:SANLUCAS
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 1:5618 NW 122ND TER
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33076-3644
Mailing Address - Country:US
Mailing Address - Phone:954-715-7769
Mailing Address - Fax:
Practice Address - Street 1:5618 NW 122ND TER
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33076-3644
Practice Address - Country:US
Practice Address - Phone:954-715-7769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies