Provider Demographics
NPI:1770936643
Name:LUNA GARCIA, PAOLA MICHELLE
Entity type:Individual
Prefix:
First Name:PAOLA
Middle Name:MICHELLE
Last Name:LUNA GARCIA
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:W7-42 CALLE GRACIANI
Mailing Address - Street 2:LADERAS DE PALMA REAL
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6811
Mailing Address - Country:US
Mailing Address - Phone:787-505-4343
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 3 KM. 8.3
Practice Address - Street 2:AVE 65 DE INFANTERIA
Practice Address - City:CAROLINA
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00984
Practice Address - Country:UM
Practice Address - Phone:787-769-4520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program