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NPI Code Detail

MEDICARE: MARIANA LUCENA

MEDICARE:   MARIANA  LUCENA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835X0200XOncology Pharmacist03236742OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PS54871OTHERFLPHARMACIST LICENSE
203236742OTHEROHPHARMACIST LICENSE
325013OTHERNCPHARMACIST LICENSE

General Provider Information

NPI Number : 1114480480
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIANA LUCENA
Provider Business Mailing Address
First Line : 9500 EUCLID AVE # HB-105
Second Line :
City : CLEVELAND
State : OH
Zip : 44195-0001
Country : US
Telephone Number : 216-314-7193
Fax Number :
Provider Business Practice Location Address
First Line : 9500 EUCLID AVE # HB
Second Line :
City : CLEVELAND
State : OH
Zip : 44195-0001
Country : US
Telephone Number : 216-314-7193
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2019
Last Update Date : 04/12/2019

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Directions to “ MARIANA LUCENA ” Practice Location

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