Individual
MIGUEL A LUNA RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4631 N CONGRESS AVE STE 100, WEST PALM BEACH, FL 33407-3209
(561) 764-2750
Mailing address
4631 N CONGRESS AVE STE 100, WEST PALM BEACH, FL 33407-3209
(561) 764-2750
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
23780
ZZ
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
35.136534
OH
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
ME163514
FL
207VG0400X
Gynecology Physician
35.136534
OH
Other
Enumeration date
06/29/2012
Last updated
09/04/2024
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