Organization Active NPI

Luminara Vindi LLC

  • Adult Development & Aging Psychologist
  • St Petersburg, FL
National Provider Identifier
1619417250
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Development & Aging PsychologistTaxonomy code 103TA0700X
Legal business name
LUMINARA VINDI LLC
Practice address
300 2ND Ave South East #83
Saint Petersburg, FL 33701-3370
Phone
(727) 906-6185
NPI assigned
Mar 1, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Thomas G QuinlanNPI 1356539837
Title
Clinical Psychology
Phone
(727) 906-6185

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Development & Aging PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TA0700X Primary

Addresses

Primary practice location

300 2ND Ave South East #83
Saint Petersburg, FL 33701-3370

Mailing address

300 2ND Ave South East
#83
Saint Petersburg, FL 33701-2023
Phone (727) 906-6185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170412002022 FL Part B Supplier - Clinic/Group Practice 1254617970 Receives reassigned benefits from 1 practitioner
Practice locations: St Petersburg, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1488326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700179200000",
    "number": "1619417250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 2ND AVE SOUTH EAST",
            "address_2": "#83",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337012023",
            "telephone_number": "727-906-6185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 2ND AVE SOUTH EAST #83",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337013370",
            "telephone_number": "727-906-6185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMINARA VINDI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-01",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-16",
        "status": "A",
        "authorized_official_last_name": "QUINLAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGY",
        "authorized_official_telephone_number": "727-906-6185"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Adult Development & Aging",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.