Most Relevant Information
Provider Data
| NPI Number: | 1003044900 |
| Provider Name: | JOSE ENCARNACION LUCIO |
| Entity Type: | Individual |
| Taxonomy Code: | 247200000X |
| Specialty: | Technician, Other |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/30/2009 |
| Last Updated: | 01/24/2012 |
Provider Practice Location
113 LIELMANIS AVE
HURLBURT FIELD
FL
325445613
Practice Location Phone/Fax
| Phone: | 8508815855 |
| Fax: |
Provider Mailing Location
113 LIELMANIS AVE
HURLBURT FIELD
FL
325445613
Provider Mailing Phone/Fax
| Phone: | 8508815855 |
| Fax: |