Provider Demographics
NPI:1871633750
Name:ARYAN, LUMA I (RPH)
Entity Type:Individual
Prefix:
First Name:LUMA
Middle Name:I
Last Name:ARYAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15482 SW 115TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-6310
Mailing Address - Country:US
Mailing Address - Phone:305-374-5120
Mailing Address - Fax:
Practice Address - Street 1:111 NW 1ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33128-1902
Practice Address - Country:US
Practice Address - Phone:305-374-5120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS33143183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS33143OtherFL MEDICAL LICENSE