Healthcare Provider Details

I. General information

NPI: 1902727795
Provider Name (Legal Business Name): LUMIERE ACADEMY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12778 SW 248TH ST
PRINCETON FL
33032-6077
US

IV. Provider business mailing address

12778 SW 248TH ST
PRINCETON FL
33032-6077
US

V. Phone/Fax

Practice location:
  • Phone: 786-925-7016
  • Fax:
Mailing address:
  • Phone: 786-925-7016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ELISA FERRO GIGATO
Title or Position: OWNER
Credential:
Phone: 786-925-7016