Provider Demographics
NPI:1700078847
Name:TUCKEER, TRUDY LYNN (RRT)
Entity Type:Individual
Prefix:MS
First Name:TRUDY
Middle Name:LYNN
Last Name:TUCKEER
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3191 HARDING ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-4436
Mailing Address - Country:US
Mailing Address - Phone:954-559-1997
Mailing Address - Fax:
Practice Address - Street 1:3191 HARDING ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-4436
Practice Address - Country:US
Practice Address - Phone:954-559-1997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-13
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT5495227900000X
CA00024192227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered