| Lumina Wellness Group Llc | |
|
737 North West 135th Avenue Pembroke Pines FL 33028 | |
| (786) 200-7553 | |
| Not Available |
| Full Name | Lumina Wellness Group Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 737 North West, Pembroke Pines, Florida |
| Authorized Official Name and Position | Alexander Stephens (OWNER) |
| Authorized Official Contact | 7862007553 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lumina Wellness Group Llc 2114 N Flamingo Rd # 5034 Pembroke Pines FL 33028-3501 Ph: (786) 200-7553 | Lumina Wellness Group Llc 737 North West 135th Avenue Pembroke Pines FL 33028 Ph: (786) 200-7553 |
| NPI Number | 1215748934 |
|---|---|
| Provider Enumeration Date | 01/14/2025 |
| Last Update Date | 01/12/2026 |
| Certification Date | 01/12/2026 |
| Medicare PECOS PAC ID | 6406377746 |
|---|---|
| Medicare Enrollment ID | O20250304000562 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215748934 | NPI | - | NPPES |
| Provider Name | Winston Odel Guevara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932674785 PECOS PAC ID: 2567899669 Enrollment ID: I20200303000235 |
| Provider Name | Alexander Stephens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811659758 PECOS PAC ID: 3577932797 Enrollment ID: I20221212000017 |
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