Individual
LUKE SIMON OLIVERA YUHICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1005 MAR WALT DRIVE, PULMONOLOGY DEPARTMENT, FORT WALTON BEACH, FL 32547-6796
(850) 243-0118
(850) 243-0594
Mailing address
1005 MAR WALT DRIVE, PULMONOLOGY DEPARTMENT, FORT WALTON BEACH, FL 32547-6796
(850) 243-0118
(850) 243-0594
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
ME125855
FL
207RP1001X
Pulmonary Disease Physician
Primary
ME125855
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015897100
—
FL
01
—
SRQW6
BCBSFL
FL
Enumeration date
05/09/2009
Last updated
01/23/2017
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