Provider Demographics
NPI:1861850497
Name:LUYANDO, MARIANGIE (LMT)
Entity Type:Individual
Prefix:
First Name:MARIANGIE
Middle Name:
Last Name:LUYANDO
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:DD 26 CALLE E
Mailing Address - Street 2:URB. LUQUILLO MAR
Mailing Address - City:LUQUILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00773
Mailing Address - Country:US
Mailing Address - Phone:939-969-0496
Mailing Address - Fax:
Practice Address - Street 1:DD 26 CALLE E
Practice Address - Street 2:URB. LUQUILLO MAR,
Practice Address - City:LUQUILLO
Practice Address - State:PR
Practice Address - Zip Code:00773
Practice Address - Country:US
Practice Address - Phone:939-969-0496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-10
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0171225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist