Provider Demographics
NPI:1033963392
Name:LUNELLA ENTERPRISES
Entity Type:Organization
Organization Name:LUNELLA ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARLY
Authorized Official - Middle Name:IRENE
Authorized Official - Last Name:GALLAGHER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:321-877-5244
Mailing Address - Street 1:1600 W EAU GALLIE BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-4149
Mailing Address - Country:US
Mailing Address - Phone:321-987-0041
Mailing Address - Fax:
Practice Address - Street 1:1600 W EAU GALLIE BLVD STE 203
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-4149
Practice Address - Country:US
Practice Address - Phone:321-987-0041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty