Provider Demographics
NPI:1083685945
Name:FIGUEROA, LUIS G (MD)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:G
Last Name:FIGUEROA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 DREW ST
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-3305
Mailing Address - Country:US
Mailing Address - Phone:727-797-7463
Mailing Address - Fax:727-216-0374
Practice Address - Street 1:2250 DREW ST
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-3305
Practice Address - Country:US
Practice Address - Phone:727-797-7463
Practice Address - Fax:727-216-0374
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME661102084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF68524Medicare UPIN
FL25281Medicare ID - Type Unspecified