Provider Demographics
NPI:1366200818
Name:MUSCADIN, LUCINDA ADELSON
Entity type:Individual
Prefix:
First Name:LUCINDA
Middle Name:ADELSON
Last Name:MUSCADIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 CORPORATE DR STE 100S8A
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-6600
Mailing Address - Country:US
Mailing Address - Phone:561-288-2517
Mailing Address - Fax:
Practice Address - Street 1:1501 CORPORATE DR STE 100S8A
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-6600
Practice Address - Country:US
Practice Address - Phone:561-288-2517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL176B00000X
FL11031550367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife