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Individual

DR. MARK S LUEDKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
9433 BALM RIVERVIEW RD STE 102, RIVERVIEW, FL 33569-5120
(813) 671-2020
(813) 677-5549
Mailing address
9433 BALM RIVERVIEW RD, STUITE 102, RIVERVIEW, FL 33569-5120
(813) 671-2020
(813) 677-5549

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC2762
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
620037100
FL
Enumeration date
03/14/2006
Last updated
05/27/2015
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