Lusco, Mattie G
Lusco, Mattie G is an sole proprietor health care provider with primary practice located at 623 Beechwood St , Jacksonville FL 32206-6236. She recently has only one registered license in Agencies / Case Management, which is considered as her primary health care specialty. Lusco, Mattie G can be contacted via phone (904) 358-1211.Contact Information
Primary practice address
623 Beechwood St
Jacksonville FL 32206-6236
Phone: (904) 358-1211
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Agencies / Case Management | 251B00000X |
Profile Details
| NPI number | 1235412206 |
|---|---|
| LBN Legal business name | Lusco, Mattie G |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 26th, 2011 |
| Last updated | Dec 16th, 2011 - about 13 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 | 1235412206 | NPPES |
| Florida | MEDICAID | 675446500 |
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