Organization
GLOWTOX STUDIO LLC
Active
Other names
Allergy and Asthma Care.
Organization subpart
No
Provider details
NPI number
Authorized official
LUIS ENRIQUE MORERA APRN (AUTHORIZED OFFICIAL)
(305) 979-7195
Entity
Organization
Contact information
Practice address
3228 SW MARTIN DOWNS BLVD STE 200, PALM CITY, FL 34990-2680
(772) 223-0620
(772) 223-0640
Mailing address
1914 SW NOTRE DAME AVE, PORT ST LUCIE, FL 34953-2469
(305) 979-7195
(262) 425-8964
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102375000
—
FL
01
—
14440985
CAQH
FL
Enumeration date
04/26/2025
Last updated
09/30/2025
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