Healthcare Provider Details

I. General information

NPI: 1053223966
Provider Name (Legal Business Name): MEDIA LUNA FAMILY CARE SERVICES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 W 49TH ST STE 502
HIALEAH FL
33012-2950
US

IV. Provider business mailing address

1840 W 49TH ST STE 502
HIALEAH FL
33012-2950
US

V. Phone/Fax

Practice location:
  • Phone: 561-595-1032
  • Fax:
Mailing address:
  • Phone: 561-595-1032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: YUDISMAR SANCHEZ BARRAL
Title or Position: PRESIDENT
Credential:
Phone: 561-595-1032