Provider Demographics
NPI:1457946691
Name:LUNDI, EVA
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:LUNDI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19920 NE 2ND CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-2924
Mailing Address - Country:US
Mailing Address - Phone:786-991-4512
Mailing Address - Fax:
Practice Address - Street 1:6096 YERBA BUENA CT
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-7410
Practice Address - Country:US
Practice Address - Phone:786-991-4512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services