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NPI Code Detail

MEDICARE: MRS. LUNA SAMMAN GRUHONJIC DO

MEDICARE: MRS. LUNA SAMMAN GRUHONJIC DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1417798810
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LUNA SAMMAN GRUHONJIC DO
Provider Business Mailing Address
First Line : 250 WIRE DR UNIT 101
Second Line :
City : LAKELAND
State : FL
Zip : 33815-4466
Country : US
Telephone Number : 973-856-5306
Fax Number :
Provider Business Practice Location Address
First Line : 1475 W 49TH PL
Second Line :
City : HIALEAH
State : FL
Zip : 33012-3113
Country : US
Telephone Number : 305-558-2500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2024
Last Update Date : 05/12/2026

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