Provider Demographics
NPI:1538644190
Name:SEGOVIA, LUCIA D (ARNP)
Entity type:Individual
Prefix:MRS
First Name:LUCIA
Middle Name:D
Last Name:SEGOVIA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MRS
Other - First Name:LUCIA
Other - Middle Name:D
Other - Last Name:SEGOVIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:7171 N DALE MABRY HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-2665
Mailing Address - Country:US
Mailing Address - Phone:813-396-6862
Mailing Address - Fax:
Practice Address - Street 1:7171 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2665
Practice Address - Country:US
Practice Address - Phone:813-396-6862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-30
Last Update Date:2018-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9222556363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner