Provider Demographics
NPI:1194592022
Name:MARTINEZ LUNA, RAFAEL ALBERTO
Entity type:Individual
Prefix:
First Name:RAFAEL
Middle Name:ALBERTO
Last Name:MARTINEZ LUNA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5927 LK PT VILLAGE CIR APT 810
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-3565
Mailing Address - Country:US
Mailing Address - Phone:201-973-6568
Mailing Address - Fax:
Practice Address - Street 1:5927 LK PT VILLAGE CIR APT 810
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-3565
Practice Address - Country:US
Practice Address - Phone:201-973-6568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)