Glow Med Lounge LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

GLOW MED LOUNGE LLC

Practice address

723 Worlington LN
Fort Pierce, FL 34947-1351

Phone

(787) 923-1116

NPI assigned

May 17, 2024

Organization subpart

No

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

Authorized official

Name

Coralis M Pena Santana, APRN

Title

Owner-Aprn

Phone

(787) 923-1116

Specialties & licenses 1

Addresses

Practitioners 1

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

• Coralis Del Mar Pena Santana, APRN

  • Acute Care Nurse Practitioner
  • Miami, FL
  • NPI 1154093854
  NPD

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

{
    "created_epoch": "1715904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715904000000",
    "number": "1841049152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 WORLINGTON LN",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349471351",
            "telephone_number": "787-923-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 WORLINGTON LN",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349471351",
            "telephone_number": "787-923-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLOW MED LOUNGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-17",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A",
        "authorized_official_last_name": "PENA SANTANA",
        "authorized_official_first_name": "CORALIS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER-APRN",
        "authorized_official_telephone_number": "787-923-1116",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary-Ann Girgis, P.A.-C
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• Theresa Gizze
• Glidden Park Inpatient Services, LLC
• Gloria E McNeil MD., PL
• Go Checkpoint
• John Patrick Goggin, DPM
• Harlene Goldberg
• Latashia Golden
• Toussaint Golding

• Nurse Practitioner in Fort Pierce, FL
• Providers in Fort Pierce, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.