Provider Demographics
NPI:1992200158
Name:JAMES LUCIO MD, PA
Entity Type:Organization
Organization Name:JAMES LUCIO MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-902-6252
Mailing Address - Street 1:2582 MAGUIRE RD # 187
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-4749
Mailing Address - Country:US
Mailing Address - Phone:407-489-8501
Mailing Address - Fax:
Practice Address - Street 1:12627 BUTLER BAY CT
Practice Address - Street 2:
Practice Address - City:WINDERMERE
Practice Address - State:FL
Practice Address - Zip Code:34786-6102
Practice Address - Country:US
Practice Address - Phone:407-489-8501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-28
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty