1568107282 NPI number — JOSE ANTONIO LUNA ALVAREZ AMEZQUITA M.D.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568107282 NPI number — JOSE ANTONIO LUNA ALVAREZ AMEZQUITA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LUNA ALVAREZ AMEZQUITA
Provider First Name:
JOSE
Provider Middle Name:
ANTONIO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568107282
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/25/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
02/08/2023
NPI Reactivation Date:
01/27/2025

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
RIO LERMA 137
Provider Second Line Business Mailing Address:
APARTMENT 3, COLONIA CUAUHTEMOC, ALCALDIA CUAUHTEMOC
Provider Business Mailing Address City Name:
MEXICO CITY
Provider Business Mailing Address State Name:
MEXICO
Provider Business Mailing Address Postal Code:
06500
Provider Business Mailing Address Country Code:
MX
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1611 N.W. 12TH AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33136
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-585-5212
Provider Business Practice Location Address Fax Number:
305-585-8137
Provider Enumeration Date:
04/28/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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