# ILUMINA LIFE CENTER, P.C.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295101715
- **Authorized official:** FLORENTINA MAYKO (CEO)
- **Authorized official phone:** (814) 467-4055

## Contact information

- **Practice address:** 507 TIRE HILL RD, SUITE 100, JOHNSTOWN, PA 15905-7311
- **Practice address phone:** (814) 467-4055
- **Practice address fax:** (814) 262-9816
- **Mailing address:** 136 JAYCEE DR, SUITE 10, JOHNSTOWN, PA 15904-3650
- **Mailing address phone:** (814) 467-4055
- **Mailing address fax:** (814) 626-8161

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |
| 208VP0014X | Interventional Pain Medicine Physician | — | NULL | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 08/19/2015
- **Last updated:** 05/07/2018