Provider Demographics
NPI:1962723635
Name:ELMS, LUKE M (MD)
Entity type:Individual
Prefix:
First Name:LUKE
Middle Name:M
Last Name:ELMS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9430 TURKEY LAKE RD
Mailing Address - Street 2:STE 114
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-8015
Mailing Address - Country:US
Mailing Address - Phone:407-354-1202
Mailing Address - Fax:407-351-8801
Practice Address - Street 1:9430 TURKEY LAKE RD
Practice Address - Street 2:STE 114
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-8015
Practice Address - Country:US
Practice Address - Phone:407-354-1202
Practice Address - Fax:407-351-8801
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2016-11-15
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Provider Licenses
StateLicense IDTaxonomies
FLME124048208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME124048OtherMEDICAL LICENSE
FL015073000Medicaid
FL015073000Medicaid