Provider Demographics
NPI:1427503341
Name:POWELL, LUCENA
Entity type:Individual
Prefix:
First Name:LUCENA
Middle Name:
Last Name:POWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 PEACE CT
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34759-5373
Mailing Address - Country:US
Mailing Address - Phone:914-227-5698
Mailing Address - Fax:863-226-3931
Practice Address - Street 1:430 PEACE CT
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-5373
Practice Address - Country:US
Practice Address - Phone:914-227-5698
Practice Address - Fax:863-226-3931
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-20
Last Update Date:2022-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X, 372500000X
FL372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider
Yes253Z00000XAgenciesIn Home Supportive Care
No372600000XNursing Service Related ProvidersAdult Companion
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1427503341OtherNPI