Individual
NINA L LUXENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
655 W 8TH ST # C90, JACKSONVILLE, FL 32209-6511
(904) 244-9448
(904) 244-2116
Mailing address
655 W 8TH ST # C90, JACKSONVILLE, FL 32209-6511
(904) 244-9448
(904) 244-2116
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
82209
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005546000
—
FL
01
—
14L4C
BLUE CROSS AND BLUE SHIELD
FL
01
—
P01098664
RAILROAD
FL
Enumeration date
11/21/2005
Last updated
06/11/2019
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