Provider Demographics
NPI:1659740983
Name:LUCIANO, VIONET (TS)
Entity Type:Individual
Prefix:MISS
First Name:VIONET
Middle Name:
Last Name:LUCIANO
Suffix:
Gender:F
Credentials:TS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:E40 CALLE #3
Mailing Address - Street 2:URB EL MADRIGAL
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00731-1415
Mailing Address - Country:US
Mailing Address - Phone:787-374-7476
Mailing Address - Fax:787-992-0093
Practice Address - Street 1:55 CALLE COMERCIO
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-3531
Practice Address - Country:US
Practice Address - Phone:787-246-5248
Practice Address - Fax:787-992-0093
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-16
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR118881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical