Lutz, Michael Edward
Lutz, Michael Edward is an individual health care provider with primary practice located at 4465 Baymeadows Rd Suite 5, Jacksonville FL 32217. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is his primary health care specialty. Lutz, Michael Edward can be contacted via phone (904) 737-0111.Contact Information
Primary practice address
4465 Baymeadows Rd Suite 5
Jacksonville FL 32217
Phone: (904) 737-0111
Fax: (904) 737-4422
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | ME74101 | Florida |
| Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery | 207ND0101X | ME74101 | Florida |
Profile Details
| NPI number | 1982740775 |
|---|---|
| LBN Legal business name | Lutz, Michael Edward |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 29th, 2007 |
| Last updated | Jun 28th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982740775 | NPPES |
| Other | 42484 | BCBS |
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