Denicola, Lucian Kenneth
Denicola, Lucian Kenneth is an individual health care provider with primary practice located at 800 Prudential Dr Fl 3 Ufjp Pediatric Critical Care, Jacksonville FL 32207-8202. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine. Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine is his primary health care specialty. Denicola, Lucian Kenneth can be contacted via phone (904) 202-8758.Contact Information
Primary practice address
800 Prudential Dr Fl 3 Ufjp Pediatric Critical Care
Jacksonville FL 32207-8202
Phone: (904) 202-8758
Fax: (904) 306-9884
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | ME40505 | Florida |
| Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine | 2080P0203X | ME40505 | Florida |
Profile Details
| NPI number | 1750359063 |
|---|---|
| LBN Legal business name | Denicola, Lucian Kenneth |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 11th, 2006 |
| Last updated | Aug 17th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750359063 | NPPES |
| Georgia | MEDICAID | 000252458D | |
| Georgia | Other | 810000707 | |
| Georgia | MEDICAID | 0669610-00 |
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