Basic Information
| Provider Information | |||||||||
| NPI: | 1003878935 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PICA | ||||||||
| FirstName: | LUCILLE | ||||||||
| MiddleName: | THERESE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | A.R.N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6886 TRADEWIND WAY | ||||||||
| Address2: | |||||||||
| City: | LANTANA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334624048 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5615472020 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1150 45TH ST | ||||||||
| Address2: | |||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334072361 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5615145503 | ||||||||
| FaxNumber: | 5615145540 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | ARNP 1284702 | FL | Y | Nursing Service Providers | Registered Nurse |
No ID Information.