Healthcare Provider Details
I. General information
NPI: 1053245175
Provider Name (Legal Business Name): LUNAR EYECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1347 LAMBERTON DR
SILVER SPRING MD
20902-3415
US
IV. Provider business mailing address
12312 LIMA DR
SILVER SPRING MD
20904-2047
US
V. Phone/Fax
- Phone: 240-462-9084
- Fax:
- Phone: 240-462-9084
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ROSSANA
LUNA
Title or Position: OPTOMETRIST
Credential: OD
Phone: 240-462-9084