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General NPI Number Information
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NPI Number | 1689415820
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Entity Type | Organization
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Legal Business Name | LUNA NUEVA THERAPY & CONSULTING LLC
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 13 WINDTREE LN
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City | WINTER GARDEN
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State | FL
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Zip | 34787-4300
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Country | US
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Telephone | 407-789-8839
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Fax |
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Provider Business Mailing Address
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Address Line | 3065 DANIELS RD # 1585
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City | WINTER GARDEN
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State | FL
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Zip | 34787-7002
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AMBR
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Name | FRANSHESKA M CARDONA LEON
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Credential | LCSW
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Telephone | 407-789-8839
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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