Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 11008976 | FL |
NPI | 1295342657 |
---|---|
Provider Name | Fritz Gerald Luma |
First Address | Hallandale Beach, FL 33009-4132 |
Second Address | Hallandale Beach, FL 33009-4132 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2020 |
Last Update Date | 01/10/2020 |