| Entity Name: | LUNA THERAPY SERVICES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 19 Apr 2021 (4 years ago) |
| Document Number: | L21000179899 |
| FEI/EIN Number | 86-3519898 |
| Address: | 1419 HUBBARD ST, JACKSONVILLE, FL 32206 |
| Mail Address: | 1419 HUBBARD ST, JACKSONVILLE, FL 32206 |
| ZIP code: | 32206 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982277000 | 2021-07-19 | 2021-07-19 | 1419 HUBBARD ST, JACKSONVILLE, FL, 322064533, US | 1419 HUBBARD ST, JACKSONVILLE, FL, 322064533, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 904-431-7276 |
| Fax | 9044560838 |
Authorized person
| Name | LESLEY SUMMERS |
| Role | OWNER |
| Phone | 9044317276 |
Taxonomy
| Taxonomy Code | 261QH0700X - Hearing and Speech Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | CAQH |
| Number | 14508875 |
| State | FL |
| Issuer | MEDICAID |
| Number | 103131600 |
| State | FL |
| Issuer | FLORIDA DOH |
| Number | SA18358 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SUMMERS, LESLEY | Agent | 1419 HUBBARD ST, JACKSONVILLE, FL 32206 |
| Name | Role | Address |
|---|---|---|
| SUMMERS, LESLEY | Manager | 1419 HUBBARD ST, JACKSONVILLE, FL 32206 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-12 |
| ANNUAL REPORT | 2024-01-29 |
| ANNUAL REPORT | 2023-03-03 |
| ANNUAL REPORT | 2022-03-11 |
| Florida Limited Liability | 2021-04-19 |
Date of last update: 13 Feb 2025
Sources: Florida Department of State
