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General NPI Number Information
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NPI Number | 1932919222
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Entity Type | Organization
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Legal Business Name | LUNA BEHAVIORAL HEALTH, LLC
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Dates
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Enumeration Date | 01/09/2025
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 3081 SALZEDO ST # 202-E3
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City | CORAL GABLES
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State | FL
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Zip | 33134-6722
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Country | US
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Telephone | 786-755-4801
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Fax |
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Provider Business Mailing Address
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Address Line | 3081 SALZEDO ST # 202-E3
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City | CORAL GABLES
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State | FL
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Zip | 33134-6722
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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 | PSYCHIATRIST
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Name | MARCELLO DE CARVALHO
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Credential |
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Telephone | 305-310-2927
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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