Provider Demographics
NPI:1932770674
Name:LUKOH, BLESSING EBIAKPOKUBOERE
Entity Type:Individual
Prefix:
First Name:BLESSING
Middle Name:EBIAKPOKUBOERE
Last Name:LUKOH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10484 SW 225TH TER
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33190-1395
Mailing Address - Country:US
Mailing Address - Phone:786-314-0383
Mailing Address - Fax:
Practice Address - Street 1:10484 SW 225TH TER
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33190-1395
Practice Address - Country:US
Practice Address - Phone:786-314-0383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-04
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9436291163WC0200X
FLAPRN11023805367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine