Individual
LUCAS SCOTT CORBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1865 LPGA BLVD, DAYTONA BEACH, FL 32117-7108
(386) 255-4596
(386) 258-3561
Mailing address
1865 LPGA BLVD, DAYTONA BEACH, FL 32117-7108
(386) 255-4596
(386) 258-3561
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9118565
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122115600
—
FL
Enumeration date
09/21/2022
Last updated
02/21/2025
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