Provider Demographics
NPI:1407440548
Name:LUNA, REINALDO (APRN)
Entity type:Individual
Prefix:
First Name:REINALDO
Middle Name:
Last Name:LUNA
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 OCOEE APOPKA RD STE 120
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-9210
Mailing Address - Country:US
Mailing Address - Phone:407-889-1930
Mailing Address - Fax:
Practice Address - Street 1:2100 OCOEE APOPKA RD
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-9210
Practice Address - Country:US
Practice Address - Phone:407-889-1930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-01
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11011730363LG0600X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology