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General NPI Number Information
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NPI Number | 1275930109
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Entity Type | Individual
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Provider Name | MARIA CLAUDIA DE POMBO LUNA MD
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Gender | Female
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Dates
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Enumeration Date | 11/20/2014
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Last Update Date | 05/05/2023
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Provider Practice Location Address
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Address Line | 2813 EXECUTIVE PARK DR STE 126
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City | WESTON
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State | FL
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Zip | 33331-3603
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Country | US
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Telephone | 964-614-2484
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Fax |
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Provider Business Mailing Address
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Address Line | 2813 EXECUTIVE PARK DR STE 126
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City | WESTON
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State | FL
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Zip | 33331-3603
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Country | US
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Telephone | 964-614-2484
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number | ME126382
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME126382
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License Number State | FL
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