Provider Demographics
NPI:1629832118
Name:LUNA, MONTSERRAT MEDELET
Entity Type:Individual
Prefix:
First Name:MONTSERRAT
Middle Name:MEDELET
Last Name:LUNA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 LAFAETTE ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-4617
Mailing Address - Country:US
Mailing Address - Phone:702-713-8471
Mailing Address - Fax:
Practice Address - Street 1:3430 E FLAMINGO RD STE 2003430E
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5003
Practice Address - Country:US
Practice Address - Phone:702-427-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care