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NPI Code Detail

MEDICARE: DR. LUIS MANUEL VINUELA MD

MEDICARE: DR. LUIS MANUEL VINUELA MD
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
12084P0800XPsychiatry PhysicianME0094555FL
22084P0805XGeriatric Psychiatry PhysicianME0094555FL

General Provider Information

NPI Number : 1710943311
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LUIS MANUEL VINUELA MD
Provider Business Mailing Address
First Line : 2690 RANCHWOOD CT
Second Line :
City : MELBOURNE
State : FL
Zip : 32934-7542
Country : US
Telephone Number : 321-426-9601
Fax Number :
Provider Business Practice Location Address
First Line : 400 E SHERIDAN RD
Second Line :
City : MELBOURNE
State : FL
Zip : 32901-3122
Country : US
Telephone Number : 321-722-5200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2006
Last Update Date : 09/11/2025

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