Provider Demographics
NPI:1639611304
Name:WAHNON BENAYOUN, LUNA (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:LUNA
Middle Name:
Last Name:WAHNON BENAYOUN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:LUNA
Other - Middle Name:
Other - Last Name:WAHNON DE BENAYOUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1050 93RD ST APT 5H
Mailing Address - Street 2:
Mailing Address - City:BAY HARBOR ISLANDS
Mailing Address - State:FL
Mailing Address - Zip Code:33154-2347
Mailing Address - Country:US
Mailing Address - Phone:669-235-4347
Mailing Address - Fax:
Practice Address - Street 1:7480 FAIRWAY DR STE 208
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-6879
Practice Address - Country:US
Practice Address - Phone:669-235-4347
Practice Address - Fax:786-221-4871
Is Sole Proprietor?:No
Enumeration Date:2016-11-13
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9402340363LF0000X
FLR.N.9402340163W00000X
FLA.R.N.P 9402340363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse