MEDICARE: DR. LUCIANO LUIS DIAZ GODOY DC

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
1	111N00000X	Chiropractor	1086	PR

General Provider Information

NPI Number	:	1831050368
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUCIANO LUIS DIAZ GODOY DC

Provider Business Mailing Address
First Line	:	8 CALLE CORDOVA
Second Line	:
City	:	CAGUAS
State	:	PR
Zip	:	00727-2517
Country	:	US
Telephone Number	:	787-633-1190
Fax Number	:	787-746-5433

Provider Business Practice Location Address
First Line	:	71 CARR 174
Second Line	:	URBANIZACION AGUSTIN STAHL
City	:	BAYAMON
State	:	PR
Zip	:	00956-3044
Country	:	US
Telephone Number	:	787-633-1190
Fax Number	:	787-746-5433

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/24/2025
Last Update Date	:	06/08/2026

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