Provider Demographics
NPI:1265839633
Name:AMELINGMEIER, LUNA (MD)
Entity Type:Individual
Prefix:
First Name:LUNA
Middle Name:
Last Name:AMELINGMEIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4848 E CACTUS RD
Mailing Address - Street 2:ST 505 #907
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254
Mailing Address - Country:US
Mailing Address - Phone:850-610-1016
Mailing Address - Fax:
Practice Address - Street 1:4848 E CACTUS RD
Practice Address - Street 2:ST 505 #907
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254
Practice Address - Country:US
Practice Address - Phone:850-610-1016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ61095208D00000X
PR19118208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice