| Luminescence Therapy Llc | |
|
13424 Fort King Rd Dade City FL 33525-5214 | |
| (352) 437-3559 | |
| (352) 608-9017 |
| Full Name | Luminescence Therapy Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 13424 Fort King Rd, Dade City, Florida |
| Authorized Official Name and Position | Violet T Reid (PRESIDENT) |
| Authorized Official Contact | 5619008199 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Luminescence Therapy Llc 13424 Fort King Rd Dade City FL 33525-5214 Ph: (352) 437-3559 | Luminescence Therapy Llc 13424 Fort King Rd Dade City FL 33525-5214 Ph: (352) 437-3559 |
| NPI Number | 1700508041 |
|---|---|
| Provider Enumeration Date | 09/14/2022 |
| Last Update Date | 06/16/2023 |
| Certification Date | 06/16/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700508041 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 252Y00000X | Early Intervention Provider Agency | (* (Not Available)) | Secondary |
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