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Organization
CHARLENE T. DELUCA, MD, PA
Active
Organization
CHARLENE T. DELUCA, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLENE T. DELUCA MD (PRESIDENT)
(239) 537-9037
Entity
Organization
Contact information
Practice address
6101 PINE RIDGE RD, NAPLES, FL 34119-3900
(239) 537-9037
Mailing address
6017 PINE RIDGE RD, NAPLES, FL 34119-3956
(239) 537-9037
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
ME94900
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002507100
—
FL
05
—
002753800
—
FL
01
—
56401
BLUE CROSS BLUE SHIELD OF FLORIDA
FL
01
—
Y04QU
BLUE CROSS BLUE SHIELD OF FLORIDA
FL
Enumeration date
03/08/2012
Last updated
03/08/2012
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