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General NPI Number Information
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NPI Number | 1407091903
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Entity Type | Organization
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Legal Business Name | HENRY LUJAN MD LLC
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Dates
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Enumeration Date | 12/11/2008
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Last Update Date | 03/05/2009
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Provider Practice Location Address
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Address Line | 9195 SUNSET DR SUITE 230
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City | MIAMI
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State | FL
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Zip | 33173-3488
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Country | US
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Telephone | 305-271-4814
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Fax | 305-279-1994
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Provider Business Mailing Address
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Address Line | 12200 VISTA LN
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City | PINECREST
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State | FL
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Zip | 33156-5741
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Country | US
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Telephone | 305-546-1505
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Fax | 305-668-6653
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Authorized Official
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Title or Position | PHYSICIAN DIRECTOR
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Name | HENRY LUJAN
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Credential | MD
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Telephone | 305-546-1505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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