Healthcare Provider Details

I. General information

NPI: 1346495538
Provider Name (Legal Business Name): LUMANA JOSEPH M.P.T., L.M.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LUMANA PHYSCIAL THERAPY AND WELLNESS CENTER P.T.

II. Dates (important events)

Enumeration Date: 12/01/2008
Last Update Date: 04/06/2020
Certification Date: 04/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 NE 125TH ST
NORTH MIAMI FL
33161-5712
US

IV. Provider business mailing address

810 NE 125TH ST
NORTH MIAMI FL
33161-5712
US

V. Phone/Fax

Practice location:
  • Phone: 305-450-2736
  • Fax: 305-675-3313
Mailing address:
  • Phone: 305-450-2736
  • Fax: 305-675-3313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT24092
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA26681
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: