Cristina Luciano M D P A | |
2 North Pavilion Place Penney Farms FL 32079-9207 | |
(904) 349-6344 | |
Not Available |
Full Name | Cristina Luciano M D P A |
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Speciality | General Practice |
Location | 2 North Pavilion Place, Penney Farms, Florida |
Authorized Official Name and Position | Cristina Luciano (OWNER) |
Authorized Official Contact | 9043496344 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Cristina Luciano M D P A Po Box 1004 Orange Park FL 32067-1004 Ph: (904) 349-6344 | Cristina Luciano M D P A 2 North Pavilion Place Penney Farms FL 32079-9207 Ph: (904) 349-6344 |
NPI Number | 1801073713 |
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Provider Enumeration Date | 01/23/2008 |
Last Update Date | 07/19/2023 |
Medicare PECOS PAC ID | 2163593732 |
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Medicare Enrollment ID | O20230703000190 |
Identifier | Type | State | Issuer |
---|---|---|---|
1801073713 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | ME74563 (Florida) | Primary |
Provider Name | Cristina Luciano |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1912911512 PECOS PAC ID: 3577658210 Enrollment ID: I20230703000246 |
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