Provider Demographics
NPI:1023629573
Name:LUNA SALGADO, MARIA DEL PILAR
Entity type:Individual
Prefix:
First Name:MARIA DEL PILAR
Middle Name:
Last Name:LUNA SALGADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21701 NW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-1038
Mailing Address - Country:US
Mailing Address - Phone:786-451-2196
Mailing Address - Fax:
Practice Address - Street 1:21701 NW 3RD ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-1038
Practice Address - Country:US
Practice Address - Phone:786-451-2196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBACB562506OtherBACB CREDENTIAL