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General NPI Number Information
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NPI Number | 1356033138
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Entity Type | Organization
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Legal Business Name | LUNA ACUPUNCTURE & WELLNESS
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Dates
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Enumeration Date | 05/22/2023
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Last Update Date | 05/22/2023
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Provider Practice Location Address
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Address Line | 10175 FORTUNE PKWY UNIT 901
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City | JACKSONVILLE
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State | FL
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Zip | 32256-6755
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Country | US
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Telephone | 954-802-3418
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Fax |
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Provider Business Mailing Address
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Address Line | 145 CALLISTO WAY
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City | SAINT JOHNS
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State | FL
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Zip | 32259-1229
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Country | US
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Telephone | 954-802-3418
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. NORALIZA JEAN-LOUIS
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Credential |
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Telephone | 954-802-3418
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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