Provider Demographics
NPI:1568107282
Name:LUNA ALVAREZ AMEZQUITA, JOSE ANTONIO (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:ANTONIO
Last Name:LUNA ALVAREZ AMEZQUITA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RIO LERMA 137
Mailing Address - Street 2:APARTMENT 3, COLONIA CUAUHTEMOC, ALCALDIA CUAUHTEMOC
Mailing Address - City:MEXICO CITY
Mailing Address - State:MEXICO
Mailing Address - Zip Code:06500
Mailing Address - Country:MX
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1611 N.W. 12TH AVENUE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136
Practice Address - Country:US
Practice Address - Phone:305-585-5212
Practice Address - Fax:305-585-8137
Is Sole Proprietor?:No
Enumeration Date:2022-04-28
Last Update Date:2025-02-25
Deactivation Date:2023-02-08
Deactivation Code:
Reactivation Date:2025-01-27
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program