Healthcare Provider Details

I. General information

NPI: 1497553598
Provider Name (Legal Business Name): LUMINI ADVANTAGE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2025
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 INDIAN WELLS RD STE B
ALAMOGORDO NM
88310-4611
US

IV. Provider business mailing address

432 PANHANDLE CT
ALAMOGORDO NM
88310-8518
US

V. Phone/Fax

Practice location:
  • Phone: 575-437-0890
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: CARLOS PLUTARCO SANCHEZ
Title or Position: DIRECTOR
Credential: CRNA
Phone: 347-381-9909