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Individual

MRS. DEDE LUCZAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OWNER

Contact information

Practice address
2600 SENECA DR, JACKSONVILLE, FL 32259-2117
(904) 449-1496
(904) 436-5977
Mailing address
2600 SENECA DR, JACKSONVILLE, FL 32259-2117
(904) 449-1496
(904) 436-5977

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
CGC062824
FL

Other

Enumeration date
06/16/2015
Last updated
06/16/2015
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