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Individual
LUCAS JULIO PROENCA
Active
Individual
LUCAS JULIO PROENCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT19743
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT19743
PHYSICAL THERAPY LICENSE
FL
Enumeration date
10/05/2006
Last updated
07/08/2007
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