Provider Demographics
NPI:1770701443
Name:LUNA, NELIDA (RPH)
Entity type:Individual
Prefix:MRS
First Name:NELIDA
Middle Name:
Last Name:LUNA
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:LOS CLAVELES #70
Mailing Address - Street 2:SABANERA DEL RIO
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778
Mailing Address - Country:US
Mailing Address - Phone:787-210-1251
Mailing Address - Fax:
Practice Address - Street 1:LOS CLAVELES STREET #70
Practice Address - Street 2:SABANERA DEL RIO
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778
Practice Address - Country:US
Practice Address - Phone:787-210-1251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3929183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist