Provider Demographics
NPI:1962469619
Name:LUNA, LUIS A (MD)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:A
Last Name:LUNA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:LUIS
Other - Middle Name:A
Other - Last Name:LUNA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DIPLOMATE IN ACUPUNC
Mailing Address - Street 1:CARR # 21 T3 #7 LAS LOMAS
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921
Mailing Address - Country:US
Mailing Address - Phone:787-781-3194
Mailing Address - Fax:787-774-1722
Practice Address - Street 1:CARR # 21 T3 #7 LAS LOMAS
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-781-3194
Practice Address - Fax:787-774-1722
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR53171100000X
CA8012171100000X
PR4603207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
C77346Medicare UPIN
PR25570Medicare ID - Type Unspecified