Individual ProviderCarlos LuceroFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address597 S Enota Dr NE, Gainesville, GA 30501-2545(770) 219-7777(770) 219-8420PECOS EnrollmentBased on the most recent information from CMS, provider Carlos Lucero is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1023421930Provider TypeIndividualFull NameLucero, CarlosCredentialM.D.GenderMaleSole ProprietorNoEnumeration Date6/9/2014Last Updated11/1/2022Contact InformationPractice LocationPractice Address597 S Enota Dr NE, Gainesville, GA 30501-2545Phone(770) 219-7777FaxUnlisted FaxMailing LocationMailing AddressPO Box 742616, Atlanta, GA 30374-2616Phone(770) 219-8420FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense079514Georgia