Provider Demographics
NPI:1881889293
Name:LUNA, STEPHANIE MYERS (PT)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:MYERS
Last Name:LUNA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:STEPHANIE
Other - Middle Name:ANN
Other - Last Name:MYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:4455 MEDICAL CENTER WAY
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407
Mailing Address - Country:US
Mailing Address - Phone:954-740-9286
Mailing Address - Fax:
Practice Address - Street 1:4455 MEDICAL CENTER WAY
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-3244
Practice Address - Country:US
Practice Address - Phone:561-881-0066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT23502225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist