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General NPI Number Information
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NPI Number | 1871802371
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Entity Type | Organization
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Legal Business Name | LELUMIERE,INC
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Dates
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Enumeration Date | 09/30/2010
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Last Update Date | 09/30/2010
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Provider Practice Location Address
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Address Line | 4325 SUN N LAKE BLVD SUITE 105
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City | SEBRING
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State | FL
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Zip | 33872-2171
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Country | US
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Telephone | 836-471-0050
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Fax | 863-382-4899
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Provider Business Mailing Address
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Address Line | 4325 SUN N LAKE BLVD SUITE 105
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City | SEBRING
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State | FL
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Zip | 33872-2171
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Country | US
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Telephone | 836-471-0050
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Fax | 863-382-4899
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Authorized Official
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Title or Position | MEDICAL DIRECTOR/CHAIRMAN
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Name | GABRIEL A PULIDO
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Credential | M.D.
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Telephone | 863-471-0050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173C00000X
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Taxonomy Name | Reflexologist
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License Number | MM17142
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License Number State | FL
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