Provider Demographics
NPI:1902259625
Name:LUNA, MARIA MORENA A (ARNP)
Entity Type:Individual
Prefix:
First Name:MARIA MORENA
Middle Name:A
Last Name:LUNA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 N MANGOUSTINE AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-1004
Mailing Address - Country:US
Mailing Address - Phone:407-321-1415
Mailing Address - Fax:407-321-1597
Practice Address - Street 1:305 N MANGOUSTINE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-1004
Practice Address - Country:US
Practice Address - Phone:407-321-1415
Practice Address - Fax:407-321-1597
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 2998012363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP 2998012OtherADVANCED REGISTERED NURSE PRACTITIONER