Healthcare Provider Details

I. General information

NPI: 1952634701
Provider Name (Legal Business Name): ADRIANA LUCIANO-DEL VALLE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2009
Last Update Date: 03/13/2024
Certification Date: 03/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 CELEBRATION PL STE 208
CELEBRATION FL
34747-5434
US

IV. Provider business mailing address

410 CELEBRATION PL STE 208
CELEBRATION FL
34747-5434
US

V. Phone/Fax

Practice location:
  • Phone: 877-800-0239
  • Fax: 407-566-2499
Mailing address:
  • Phone: 877-800-0239
  • Fax: 407-566-2499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number18040
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME124017
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: