Provider Demographics
NPI:1902576002
Name:LUZON, JUAN JOSE (MS SLP-CF)
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:JOSE
Last Name:LUZON
Suffix:
Gender:M
Credentials:MS SLP-CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6405 DEERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-8801
Mailing Address - Country:US
Mailing Address - Phone:919-695-7078
Mailing Address - Fax:919-867-6468
Practice Address - Street 1:6405 DEERVIEW DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-8801
Practice Address - Country:US
Practice Address - Phone:919-695-7078
Practice Address - Fax:919-867-6468
Is Sole Proprietor?:No
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program