Luedke, Mark S
Luedke, Mark S is an sole proprietor health care provider with primary practice located at 9433 Balm Riverview Rd Ste 102 , Riverview FL 33569-5120. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Luedke, Mark S can be contacted via phone (813) 671-2020.Contact Information
Primary practice address
9433 Balm Riverview Rd Ste 102
Riverview FL 33569-5120
Phone: (813) 671-2020
Fax: (813) 677-5549
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPC2762 | Florida |
Profile Details
| NPI number | 1316915481 |
|---|---|
| LBN Legal business name | Luedke, Mark S |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 14th, 2006 |
| Last updated | May 27th, 2015 - about 10 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 | 1316915481 | NPPES |
| Florida | MEDICAID | 620037100 |
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