MEDICARE: LUCIANE BASILIO ALEDI ANDRADE

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	2086S0129X	Vascular Surgery Physician	TRN44119	FL

General Provider Information

NPI Number	:	1730044876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUCIANE BASILIO ALEDI ANDRADE

Provider Business Mailing Address
First Line	:	2815 W VIRGINIA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6357
Country	:	US
Telephone Number	:	813-761-2017
Fax Number	:

Provider Business Practice Location Address
First Line	:	2815 W VIRGINIA AVE STE A
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6357
Country	:	US
Telephone Number	:	813-761-2017
Fax Number	:

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

Provider Enumeration Date	:	12/22/2025
Last Update Date	:	12/22/2025

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