Provider Demographics
NPI:1013763515
Name:LUNA MEDICAL SUPPLIES LLC
Entity Type:Organization
Organization Name:LUNA MEDICAL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DARIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCISCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-765-9438
Mailing Address - Street 1:1380 NE MIAMI GARDENS DR STE 220E
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-4709
Mailing Address - Country:US
Mailing Address - Phone:305-974-2049
Mailing Address - Fax:
Practice Address - Street 1:1380 NE MIAMI GARDENS DR STE 220E
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-4709
Practice Address - Country:US
Practice Address - Phone:305-974-2049
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies