Provider Demographics
NPI:1376931832
Name:LUNA ACUPUNCTURE, INC.
Entity Type:Organization
Organization Name:LUNA ACUPUNCTURE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURE PHYSICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:NORALIZA
Authorized Official - Middle Name:
Authorized Official - Last Name:JEAN-LOUIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-800-9842
Mailing Address - Street 1:9428 BAYMEADOWS ROAD, SUITE134
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256
Mailing Address - Country:US
Mailing Address - Phone:904-800-9842
Mailing Address - Fax:
Practice Address - Street 1:9428 BAYMEADOWS RD
Practice Address - Street 2:SUITE 134
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-7969
Practice Address - Country:US
Practice Address - Phone:904-800-9842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-06
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3421171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty