National Provider Identifier Database

MARK S LUEDKE OD PA
Corporate Health


Contact Information

MARK S LUEDKE OD PA
9433 BALM RIVERVIEW RD
STE 102
RIVERVIEW, FL33569-5120
Phone: 813-671-2020
Fax: 813-677-5549
Website:
Specialty Taxonomy Code
* Corporate Health 261QC1800X

* Indicates primary specialty

NPI Profile & details for MARK S LUEDKE OD PA

NPI Number 1134370562
Legal business name
LBN
MARK S LUEDKE OD PA
Authorized official MARK LUEDKE - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 10/03/2008
Last updated 09/25/2014 - About 12 years ago
Sole proprietor1 Not specified
Identifiers
  • FL License #: OPC2762
  • FL Medicaid: 620037100

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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