Healthcare Provider Details

I. General information

NPI: 1881521490
Provider Name (Legal Business Name): XAVIER RAFAEL LUCIANO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1575 PINE RIDGE RD STE 16
NAPLES FL
34109-2110
US

IV. Provider business mailing address

631 SE 13TH AVE APT A6
CAPE CORAL FL
33990-2933
US

V. Phone/Fax

Practice location:
  • Phone: 239-734-3481
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: