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Individual

MISS ANCY LUKOSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
15602 N DALE MABRY HWY, TAMPA, FL 33618-1606
(813) 915-5459
Mailing address
15602 N DALE MABRY HWY, TAMPA, FL 33618-1606
(813) 915-5459

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN11000953
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
114654600
FL
01
QR808
HFMG MA
FL
Enumeration date
02/20/2020
Last updated
05/01/2023
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