Individual
DR. LISA R. LUCKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
13644 WALSINGHAM RD, LARGO, FL 33774-3532
(727) 595-2519
(727) 631-0916
Mailing address
2995 DREW ST FL 2, CLEARWATER, FL 33759-3012
(727) 532-0002
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
OS10452
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119460600
—
FL
01
—
2013366
COVENTRY
FL
01
—
21924001
WELLMED
FL
01
—
21924002
WELLMED
FL
01
—
232988
UNIVERSAL
FL
01
—
342337
AVMED
FL
01
—
5799464
CIGNA
FL
01
—
9269370
AETNA
FL
Enumeration date
04/02/2009
Last updated
03/03/2026
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