Individual
DEVIANO LUBIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2445 VERDE VIEW DR, APOPKA, FL 32703-9211
(407) 761-5456
Mailing address
2445 VERDE VIEW DR, APOPKA, FL 32703-9211
(407) 761-5456
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9264339
FL
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101111000
—
FL
Enumeration date
09/09/2016
Last updated
05/11/2020
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