MR. MARK MATHEW LUCERO (NPI# 1730154790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730154790 |
| Entity Type | Individual |
| Full Name | MR. MARK MATHEW LUCERO |
| Credential | PA-C |
| Practice Address |
1000 36th St Vero Beach FL 32960-4862 |
| Mailing Address |
Po Box 644102 Vero Beach FL 32964-4102 |
| Practice Telephone | 7725674311 |
| Mailing Telephone | 7725623254 |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA9102527 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 291673800 | 05 | |
| FL | BLUE CROSS | X1617 | 01 |
| FL | RR MEDICARE | P00253782 | 01 |
| Street Address |
1000 36TH ST |
| City | VERO BEACH |
| State | FL |
| Zip Code | 32960-4862 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013919513 | Craig Joseph Romero | Physician Assistant | 1000 36th St, Vero Beach, FL 32960-4862 | 2005-08-15 |
| 1679174593 | Lisa Eleanor Bosworth | Nurse Practitioner | 1000 36th St, Vero Beach, FL 32960-4862 | 2020-11-06 |
| 1326654138 | Abigail Clarose D'souza | Anesthesiology | 1000 36th St, Vero Beach, FL 32960-4862 | 2020-09-17 |
| 1033737861 | Katelin Mcginnis | Dietitian, Registered | 1000 36th St, Vero Beach, FL 32960-4862 | 2020-07-08 |
| 1427674795 | Amber Harp | Anesthesiologist Assistant | 1000 36th St, Vero Beach, FL 32960-4862 | 2020-06-22 |
| 1447886031 | Merilee Woodman | Registered Nurse | 1000 36th St, Vero Beach, FL 32960-4862 | 2020-03-16 |
| 1588298285 | Indian River Health Services Inc | Specialist | 1000 36th St, Vero Beach, FL 32960-4862 | 2020-03-03 |
| 1215561063 | Helen Christine Clark | Advanced Practice Midwife | 1000 36th St, Vero Beach, FL 32960-4862 | 2020-03-02 |
| 1639719164 | Shaina Joseph | Nurse Practitioner | 1000 36th St, Vero Beach, FL 32960-4862 | 2020-01-13 |
| 1861039281 | Jonathan Meacham | Pharmacist | 1000 36th St, Vero Beach, FL 32960-4862 | 2019-12-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891208872 | Fresenius Medical Care Vero Beach, LLC | Clinic/Center | 1515 Indian River Blvd Ste A101, Vero Beach, FL 32960 | 2017-11-13 |
| 1972016103 | Rer Enterprises, Inc. | Durable Medical Equipment & Medical Supplies | 2436 Us 1, Vero Beach, FL 32960 | 2017-11-09 |
| 1225558141 | Robby John Caballes | Podiatrist | 3735 11th Circle Ste 201, Vero Beach, FL 32960 | 2017-06-21 |
| 1407388978 | Haley Elizabeth Stewart | Counselor | 1925 20th Street, Vero Beach, FL 32960 | 2017-04-03 |
| 1861932949 | Daniel Martin | Specialist/Technologist | 4025 20th Street, Vero Beach, FL 32960 | 2017-03-08 |
| 1770957367 | Gail Jaffe Satuloff | Counselor | Terry Mindfulness Center, 333 17th St., Suite 2t, Vero Beach, FL 32960 | 2015-11-19 |
| 1104213172 | Kimberly Ann Aikey | Massage Therapist | 1715 37th Place #3, Vero Beach, FL 32960 | 2015-04-17 |
| 1992128482 | Jean Luc Franck | Internal Medicine | 920 37th Pl Ste 105, Vero Beach, FL 32960 | 2014-02-04 |
| 1417386624 | Ocean Addiction Recovery Services, LLC | Anesthesiology | 1705 19 Pl, Ste E-2, Vero Beach, FL 32960 | 2013-11-07 |
| 1609203835 | Cynthia S. Crawford, M.d. Pa | Physical Medicine & Rehabilitation | 1986 35th Avenue, Vero Beach, FL 32960 | 2013-10-02 |
| Find all providers in zip 32960 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427657055 | Alyson Ryall | Physician Assistant | 480 Ventura Pl, Vero Beach, FL 32963-4262 | 2020-10-24 |
| 1598250623 | Marlee Knuth | Physician Assistant | 3450 11th Ct Ste 302, Vero Beach, FL 32960-5012 | 2018-07-01 |
| 1669464053 | John A Lambert | Physician Assistant | 4196 79th St, Vero Beach, FL 32967-5634 | 2005-08-22 |
| 1598309403 | Alexander Dees | Physician Assistant | 1155 35th Ln Ste 100, Vero Beach, FL 32960 | 2019-11-04 |
| 1093224669 | Donatas Dudutis | Physician Assistant | 1260 37th St Ste 102, Vero Beach, FL 32960-6567 | 2017-09-26 |
| 1043475593 | Physician Assistant Services of The Treasure Coast | Physician Assistant | 1000 36th St, Vero Beach, FL 32960-4862 | 2008-07-24 |
| 1093873226 | Indian River Assisting Services Pa | Physician Assistant | 1000 36th St, Vero Beach, FL 32960-4862 | 2006-12-04 |
| 1881623536 | Worthington S. Keville IIi | Physician Assistant | 1355 37th St, Suite 301, Vero Beach, FL 32960-7321 | 2006-07-02 |
| 1467400291 | Indian River Surgical Service Corp. | Physician Assistant | 4196 79th St, Vero Beach, FL 32967-5634 | 2006-05-04 |
| 1629043724 | Margaret G Leddy | Physician Assistant | 1155 35th Ln, Suite 100, Vero Beach, FL 32960-6521 | 2006-02-22 |
| Find all providers in VERO BEACH | ||||
| City | VERO BEACH |
| Zip Code | 32960 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.