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NPI Code Detail

MEDICARE: LUCITANIA ARACELI MEDINA PUICON

MEDICARE:   LUCITANIA ARACELI MEDINA PUICON
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
1101YM0800XMental Health CounselorFL

General Provider Information

NPI Number : 1316801376
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUCITANIA ARACELI MEDINA PUICON
Provider Business Mailing Address
First Line : 18301 S DIXIE HWY APT 405
Second Line :
City : PALMETTO BAY
State : FL
Zip : 33157-5557
Country : US
Telephone Number : 561-647-7715
Fax Number :
Provider Business Practice Location Address
First Line : 18301 S DIXIE HWY APT 405
Second Line : 405
City : PALMETTO BAY
State : FL
Zip : 33157-5557
Country : US
Telephone Number : 561-647-7715
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2025
Last Update Date : 12/15/2025

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Directions to “ LUCITANIA ARACELI MEDINA PUICON ” Practice Location

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