Healthcare Provider Details

I. General information

NPI: 1831050368
Provider Name (Legal Business Name): LUCIANO LUIS DIAZ DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/24/2025
Last Update Date: 11/24/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 CARR 174 URBANIZACION AGUSTIN STAHL
BAYAMON PR
00956-3044
US

IV. Provider business mailing address

8 CALLE CORDOVA
CAGUAS PR
00727-2517
US

V. Phone/Fax

Practice location:
  • Phone: 787-633-1190
  • Fax: 787-746-5433
Mailing address:
  • Phone: 787-633-1190
  • Fax: 787-746-5433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0200X
TaxonomyRadiology Chiropractor
License Number1086
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: