Provider Demographics
NPI:1639373681
Name:LUZUNARIS, IRIS V (MSW)
Entity Type:Individual
Prefix:MISS
First Name:IRIS
Middle Name:V
Last Name:LUZUNARIS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COND WOODLANDS # 921
Mailing Address - Street 2:ST. 876 APT.149
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-7501
Mailing Address - Country:US
Mailing Address - Phone:787-685-0409
Mailing Address - Fax:
Practice Address - Street 1:ST. NO. 2 KM 8.2
Practice Address - Street 2:BO JUAN SANCHEZ
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00960
Practice Address - Country:US
Practice Address - Phone:787-751-4014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR65991041C0700X, 283Q00000X, 322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No283Q00000XHospitalsPsychiatric Hospital
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children