| Entity Name: | GEORGE R.LUCK, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 09 Mar 2001 (24 years ago) |
| Document Number: | P01000024910 |
| FEI/EIN Number | 651098585 |
| Address: | 800 MEADOWS ROAD, BOCA RATON, FL, 33486 |
| Mail Address: | 2930 NW 28TH TERR., BOCA RATON, FL, 33434 |
| ZIP code: | 33486 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760561484 | 2006-11-03 | 2008-10-21 | 40 NE 2ND AVE, DEERFIELD BEACH, FL, 334413504, US | 800 MEADOWS RD, BOCA RATON, FL, 334862304, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 954-426-8840 |
| Fax | 9544266641 |
| Phone | +1 561-395-7100 |
Authorized person
| Name | DR. GEORGE R LUCK |
| Role | PRESIDENT |
| Phone | 9544268840 |
Taxonomy
| Taxonomy Code | 207L00000X - Anesthesiology Physician |
| License Number | ME0054460 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 207LP2900X - Pain Medicine (Anesthesiology) Physician |
| License Number | ME0054460 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 263024900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LUCK GEORGE R | Agent | 800 GLADES ROAD, BOCA RATON, FL, 33486 |
| Name | Role | Address |
|---|---|---|
| LUCK GEORGE R | Director | 800 GLADES ROAD, BOCA RATON, FL, 33486 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
