Individual
MICHAEL LUTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4131 DAY BRIDGE PL, ELLENTON, FL 34222-7236
(727) 278-6205
Mailing address
33133 RANCH RD, DADE CITY, FL 33523-9164
(727) 278-6205
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
04/22/2019
Last updated
04/22/2019
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