MS. KIMBERLY JEAN LUEDECKE (NPI# 1386054559) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386054559 |
| Entity Type | Individual |
| Full Name | MS. KIMBERLY JEAN LUEDECKE |
| Credential | ARNP |
| Practice Address |
1917 Boothe Cir Longwood FL 32750-6708 |
| Mailing Address |
1334 Ferendina Dr Deltona FL 32725 |
| Practice Telephone | 4076793337 |
| Practice Fax Number | 4076787246 |
| Mailing Telephone | 3216898013 |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2014-04-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
ARNP9244528 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
ARNP9244528 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1917 BOOTHE CIR |
| City | LONGWOOD |
| State | FL |
| Zip Code | 32750-6708 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215943360 | David S Klein | Anesthesiology | 1917 Boothe Cir, Longwood, FL 32750-6708 | 2006-07-31 |
| 1790968485 | Stages of Life Medical Institute | Anesthesiology | 1917 Boothe Cir, Longwood, FL 32750-6708 | 2007-12-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902420920 | Prn Speech Pathologists | Speech-Language Pathologist | 1704 N. Ronald Reagan Blvd, Longwood, FL 32750 | 2020-06-05 |
| 1831743368 | Shamar Anthony Marston | Nurse Anesthetist, Certified Registered | 555 W Fl - 434, Longwood, FL 32750 | 2019-08-01 |
| 1538639125 | Omega Healthcare Solutions, LLC | Case Management | 160 W. Evergreen Avenue Suite 290, Longwood, FL 32750 | 2018-11-27 |
| 1013416080 | Samantha Jane Roberts | Specialist/Technologist, Other | 163 W Bay Ave, Longwood, FL 32750 | 2018-02-06 |
| 1508375874 | Cassandra Thompson-bailey | Nurse Practitioner | 600 N Us Hwy 17 92, Suite 124, Longwood, FL 32750 | 2017-09-29 |
| 1740799535 | Cornerstone Longwood Leasing, LLC | Assisted Living Facility | 480 E. Church Ave., Longwood, FL 32750 | 2017-09-25 |
| 1659890523 | Melissa Shoshana Vigerito | Marriage & Family Therapist | 978 Douglas Ave. Suite 100, Altamonte Springs, FL 32750 | 2017-09-12 |
| 1619498185 | Calm Relief, LLC | Massage Therapist | 1855 W State Road 434, Ste 253, Longwood, FL 32750 | 2017-07-05 |
| 1497145148 | Caitlin Rhea Hilligas | Counselor | 300 N Ronald Reagan Blvd Ste 302, Longwood, FL 32750 | 2015-02-03 |
| 1316344054 | James David Rawlins Jr. | Dentist | 1250 W.s.r 434 Ste. 1008, Longwood, FL 32750 | 2014-11-24 |
| Find all providers in zip 32750 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023486032 | Lydia Adebola Onatunde | Nurse Practitioner | 2062 Ackola Pt, Longwood, FL 32779-3112 | 2015-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124629902 | Tara-kaye Clunis | Nurse Practitioner | 832 Nw 130th Ave, Pembroke Pines, FL 33028-3135 | 2020-11-06 |
| 1184225112 | Dante Strong | Nurse Practitioner | 208 Afton Sq Unit 301, Altamonte Springs, FL 32714-3841 | 2020-11-05 |
| 1730780354 | Mary Catherine Grissom | Nurse Practitioner | 2093 Appalachee Cir, Tavares, FL 32778-2001 | 2020-11-02 |
| 1942800974 | Justo J Ruiz | Nurse Practitioner | 11740 Sw 26th Ter, Miami, FL 33175-2451 | 2020-10-28 |
| 1891395208 | Jordyn Lee Platt | Nurse Practitioner | 1820 Coyote Pl, Brandon, FL 33511-1741 | 2020-10-27 |
| 1669071668 | Karine Erica Cameron | Nurse Practitioner | 12028 Sw 12th St, Pembroke Pines, FL 33025-3740 | 2020-10-21 |
| 1306443916 | Simmy Regin Varghese | Nurse Practitioner | 1613 Hammock Grove Ln, Jacksonville, FL 32225-5575 | 2020-10-06 |
| 1891302469 | Shannon Bre Anna Watkins | Nurse Practitioner | 2937 Quantum Lakes Dr, Boynton Beach, FL 33426-8303 | 2020-09-28 |
| 1114534856 | Cristina Sandu | Nurse Practitioner | 19327 Elston Way, Estero, FL 33928-6489 | 2020-09-27 |
| 1215543590 | Kam Lieng Lady | Nurse Practitioner | 12031 Nw 2nd Dr, Coral Springs, FL 33071-8012 | 2020-09-22 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.