Healthcare Provider Details
I. General information
NPI: 1235508672
Provider Name (Legal Business Name): LINDSAY JOWERS LUNA PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/16/2015
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1111 W FAIRBANKS AVE STE 220
WINTER PARK FL
32789-4777
US
IV. Provider business mailing address
1111 W FAIRBANKS AVE STE 220
WINTER PARK FL
32789-4777
US
V. Phone/Fax
- Phone: 407-635-5543
- Fax: 321-842-4002
- Phone: 407-635-5543
- Fax: 321-842-4002
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | PAT9109007 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: