Provider Demographics
NPI:1184807570
Name:LUCCHESI, MARIA A (PHD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:A
Last Name:LUCCHESI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1398 SW 160TH AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33326-1988
Mailing Address - Country:US
Mailing Address - Phone:305-867-6856
Mailing Address - Fax:305-397-1523
Practice Address - Street 1:1398 SW 160TH AVE STE 302
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33326-1988
Practice Address - Country:US
Practice Address - Phone:305-867-6856
Practice Address - Fax:305-397-1523
Is Sole Proprietor?:No
Enumeration Date:2007-12-09
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6795103TC2200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent