Provider Demographics
NPI:1710617741
Name:LUNA HOME HEALTH AGENCY INC
Entity Type:Organization
Organization Name:LUNA HOME HEALTH AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-803-1974
Mailing Address - Street 1:9703 S DIXIE HWY STE 110
Mailing Address - Street 2:
Mailing Address - City:PINECREST
Mailing Address - State:FL
Mailing Address - Zip Code:33156-2812
Mailing Address - Country:US
Mailing Address - Phone:305-803-1974
Mailing Address - Fax:305-489-7662
Practice Address - Street 1:9703 S DIXIE HWY STE 110
Practice Address - Street 2:
Practice Address - City:PINECREST
Practice Address - State:FL
Practice Address - Zip Code:33156-2812
Practice Address - Country:US
Practice Address - Phone:305-803-1974
Practice Address - Fax:305-489-7662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health