Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | DN14049 | FL |
NPI | 1093935587 |
---|---|
Provider Name | Dr. Eileen M Lujan |
First Address | Miami, FL 33135-1040 |
Second Address | Miami, FL 33135-1040 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2007 |
Last Update Date | 30/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DN14049 | DENTAL LICENSE (01) | FL |