Provider Demographics
NPI:1790216158
Name:PAYNE, LUCIANA (DC)
Entity Type:Individual
Prefix:DR
First Name:LUCIANA
Middle Name:
Last Name:PAYNE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3928 S EAST AVE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-4504
Mailing Address - Country:US
Mailing Address - Phone:716-541-5528
Mailing Address - Fax:
Practice Address - Street 1:7242 BENEVA RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238-2806
Practice Address - Country:US
Practice Address - Phone:941-922-4222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-27
Last Update Date:2018-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11917111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor