MEDICARE: ROSSANA LUNA OD

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
1	152W00000X	Optometrist	OEG002353	PA
2	152W00000X	Optometrist	TA2449	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457664302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSSANA LUNA OD

Provider Business Mailing Address
First Line	:	831 UNIVERSITY BLVD E STE 11
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20903-2921
Country	:	US
Telephone Number	:	301-431-0431
Fax Number	:	301-431-0470

Provider Business Practice Location Address
First Line	:	831 UNIVERSITY BLVD E STE 11
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20903-2921
Country	:	US
Telephone Number	:	301-431-0431
Fax Number	:	301-431-0470

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2010
Last Update Date	:	02/24/2023

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Directions to “ ROSSANA LUNA OD” Practice Location

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