| Glowtox Studio Llc | |
|
3228 Sw Martin Downs Blvd Ste 200 Palm City FL 34990-2680 | |
| (772) 223-0620 | |
| (772) 223-0640 |
| Full Name | Glowtox Studio Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 3228 Sw Martin Downs Blvd Ste 200, Palm City, Florida |
| Authorized Official Name and Position | Luis Enrique Morera (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 3059797195 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Glowtox Studio Llc 1914 Sw Notre Dame Ave Port St Lucie FL 34953-2469 Ph: (305) 979-7195 | Glowtox Studio Llc 3228 Sw Martin Downs Blvd Ste 200 Palm City FL 34990-2680 Ph: (772) 223-0620 |
| NPI Number | 1851189260 |
|---|---|
| Provider Enumeration Date | 04/26/2025 |
| Last Update Date | 09/30/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851189260 | NPI | - | NPPES |
| 102375000 | Medicaid | FL | |
| 14440985 | Other | FL | CAQH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
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