Provider Demographics
NPI:1972738011
Name:LUCACI, ELENA (LMT)
Entity type:Individual
Prefix:MRS
First Name:ELENA
Middle Name:
Last Name:LUCACI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 19TH ST
Mailing Address - Street 2:STE D
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-3628
Mailing Address - Country:US
Mailing Address - Phone:772-532-9125
Mailing Address - Fax:
Practice Address - Street 1:1408 19TH ST
Practice Address - Street 2:STE D
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-3628
Practice Address - Country:US
Practice Address - Phone:772-532-9125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-19
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA50296225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist