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Individual
LUAR SANDOVAL
Active
Individual
LUAR SANDOVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
261QM1102X
Military Outpatient Operational (Transportable) Component Clinic/Center
PA9116542
FL
363A00000X
Physician Assistant
Primary
PA17558
TX
363A00000X
Physician Assistant
PA9116542
FL
Other
Enumeration date
04/25/2012
Last updated
08/14/2025
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