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Individual

ENRIQUE LUNA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC, LAT, LMT

Contact information

Practice address
2351 MALABAR RD NW, PALM BAY, FL 32907-7203
(321) 722-4178
Mailing address
879 HIGHLAND AVE NW, PALM BAY, FL 32907-7732
(321) 953-5803

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL 1073
FL
225700000X
Massage Therapist
MA 46769
FL

Other

Enumeration date
07/31/2014
Last updated
07/31/2014
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