Individual
LUCIANO JOHN RADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6550 N FEDERAL HWY, STE 512, FT LAUDERDALE, FL 33308-1404
(954) 267-8777
(954) 772-7801
Mailing address
6550 N FEDERAL HWY, STE 512, FT LAUDERDALE, FL 33308-1404
(954) 267-8777
(954) 772-7801
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9104117
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292960100
—
FL
01
—
AH414Z
MEDICARE PTAN
FL
Enumeration date
08/10/2007
Last updated
11/03/2009
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