Provider Demographics
NPI:1497994396
Name:LUNARDI, RITA A (LMT)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:A
Last Name:LUNARDI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 WILLOWWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32724-1350
Mailing Address - Country:US
Mailing Address - Phone:386-747-5700
Mailing Address - Fax:
Practice Address - Street 1:21 WILLOWWOOD TRL
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32724-1350
Practice Address - Country:US
Practice Address - Phone:386-747-5700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-17
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA31496225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist