Luedtke, Jon Robert

Luedtke, Jon Robert is an sole proprietor health care provider with primary practice located at 1501 Viscaya Pkwy Suite 2, Cape Coral FL 33990-6207. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Luedtke, Jon Robert can be contacted via phone (239) 772-8866.

Contact Information

Primary practice address
1501 Viscaya Pkwy Suite 2 Cape Coral FL 33990-6207
Phone: (239) 772-8866
Fax: (239) 772-7117
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X PS25896 Florida

Profile Details

NPI number 1902920838
LBN Legal business name Luedtke, Jon Robert
Credentials RPH
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 17th, 2007
Last updated Jul 8th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902920838 NPPES
Florida MEDICAID 109745800

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