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Individual

ANGEL A LUCIANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
119 OAKFIELD DR, BRANDON, FL 33511-5779
(813) 571-5373
(727) 767-4391
Mailing address
2501 N ORANGE AVE STE 446, ORLANDO, FL 32804-4644
(407) 303-2528

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME107390
FL
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
ME107390
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002362900
FL
01
149JR
BLUE SHIELD
FL
Enumeration date
10/13/2006
Last updated
05/03/2022
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