Individual
J. ENRIQUE LUJAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
160 E REDSTONE AVE, CRESTVIEW, FL 32539-5348
(850) 689-0555
(850) 689-3531
Mailing address
160 E REDSTONE AVE, CRESTVIEW, FL 32539-5348
(850) 689-0555
(850) 689-3531
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
54171
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07962
BC BS PROVIDER NO.
FL
Enumeration date
03/15/2007
Last updated
07/09/2007
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