MEDICARE: NAISHALIE SANTOS LUCIANO

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	103TC1900X	Counseling Psychologist	6293

General Provider Information

NPI Number	:	1922989458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAISHALIE SANTOS LUCIANO

Provider Business Mailing Address
First Line	:	CALLE SARRIA 402
Second Line	:	URB VALENCIA
City	:	SAN JUAN
State	:	PR
Zip	:	00923
Country	:	US
Telephone Number	:	787-214-9499
Fax Number	:

Provider Business Practice Location Address
First Line	:	1551 CALLE VICTORIA
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00912-3123
Country	:	US
Telephone Number	:	787-722-9595
Fax Number	:	787-722-9595

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

Provider Enumeration Date	:	09/10/2025
Last Update Date	:	09/10/2025

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Directions to “ NAISHALIE SANTOS LUCIANO ” Practice Location

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