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Individual

ROBERT E LUCKEY JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
2306 GREENBRANCH DR, SUITE #102, WESLEY CHAPEL, FL 33544
(813) 866-4004
(813) 866-4005
Mailing address
8614 WESTWOOD CENTER DR FL 9, VIENNA, VA 22182-2442
(703) 847-8899
(571) 223-6780

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC3815
FL
152WC0802X
Corneal and Contact Management Optometrist
OPC 3815
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
620881900
FL
Enumeration date
03/31/2007
Last updated
01/18/2023
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