Individual
DR. DEEPA VADUTHALAKUZHY LUKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
15901 BASS RD STE 108, FORT MYERS, FL 33908-3838
(239) 343-6050
(239) 343-6051
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-6050
(239) 343-6051
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
52798
SC
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
ME160807
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119276600
—
FL
Enumeration date
06/22/2018
Last updated
09/29/2023
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