MR. RONALD A LUSCOMB


Address: 16110 Redington Drive, Redington Beach, FL 33708
Phone: 7274340243

MR. RONALD A LUSCOMB (NPI# 1952535973) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1952535973
Entity Type Individual
Full Name MR. RONALD A LUSCOMB
Credential ARNP
Practice Address 16110 Redington Drive
Redington Beach
FL 33708
Mailing Address 16110 Redington Dr
Redington Beach
FL 33708-1631
Practice Telephone 7274340243
Mailing Telephone 7274340243
Enumeration Date 2009-05-05
Last Update Date 2012-01-10
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP2300X Nurse Practitioner
Specialization: Primary Care
ARNP3359702 FL Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
FL BCBS Y04N2 01
FL 003379500 05

Office Location

Street Address 16110 REDINGTON DRIVE
City REDINGTON BEACH
State FL
Zip Code 33708

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1962630277 Rebekah Anne Smith Optometrist 15037 Madeira Way, Madeira Beach, FL 33708 2009-06-25
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Taxonomy Information

Taxonomy Code 363LP2300X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Primary Care

Taxonomy Definition

Definition to come...

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Competitor

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City REDINGTON BEACH
Zip Code 33708

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Dataset Information

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.

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