Provider Demographics
NPI:1104833854
Name:LUGO, MIGUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:
Last Name:LUGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:661 E ALTAMONTE DR
Mailing Address - Street 2:SUITE 223
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-5105
Mailing Address - Country:US
Mailing Address - Phone:407-260-2255
Mailing Address - Fax:407-260-2831
Practice Address - Street 1:661 E ALTAMONTE DR
Practice Address - Street 2:SUITE 223
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-5105
Practice Address - Country:US
Practice Address - Phone:407-260-2255
Practice Address - Fax:407-260-2831
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0050051207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD60990Medicare UPIN