Male or Other

Widmarck Luberisse Sr BHCM

Community/Behavioral Health Agency in Orlando, FL(View on Map)

Full Name

Widmarck Luberisse Sr BHCM

NPI Number

1437724721

NPI Type

Individual Provider

Gender

Male

Enumeration Date

05/20/2021

Specialties

(Taxonomies)

Code

251S00000X
251B00000X

Primary Taxonomy

Yes
No

Licenses

State

Florida

License Number

101674

Contact
Information

Purpose

Mailing
Location

Address

929 WILSON RIDGE DR APT 1920
929 WILSON RIDGE DR APT 1920

City

Orlando
Orlando

State

FL
FL

Postal Code

32818-6550
32818-6550

Country

US
US

Telephone Number

(305) 502-8336
(305) 502-8336

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 05/20/2021

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