Healthcare Provider Details

I. General information

NPI: 1972261105
Provider Name (Legal Business Name): LUZ E NARANJO RPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2021
Last Update Date: 12/05/2021
Certification Date: 12/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 HATTERAS LN
HOLLYWOOD FL
33019-5069
US

IV. Provider business mailing address

PO BOX 223187
HOLLYWOOD FL
33022-3187
US

V. Phone/Fax

Practice location:
  • Phone: 954-445-1461
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6983
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: