Provider Demographics
NPI:1740335652
Name:LUCIANOS URGENT CARE
Entity type:Organization
Organization Name:LUCIANOS URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCIANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-291-2221
Mailing Address - Street 1:3360 COUNTY ROAD 220
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:FL
Mailing Address - Zip Code:32068-4359
Mailing Address - Country:US
Mailing Address - Phone:904-291-2221
Mailing Address - Fax:904-282-6332
Practice Address - Street 1:3360 COUNTY ROAD 220
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:FL
Practice Address - Zip Code:32068-4359
Practice Address - Country:US
Practice Address - Phone:904-291-2221
Practice Address - Fax:904-282-6332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0074563174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty