Provider Demographics
NPI:1184680084
Name:PODESTA, LUGA (MD)
Entity Type:Individual
Prefix:DR
First Name:LUGA
Middle Name:
Last Name:PODESTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 VETERANS PARK DR
Mailing Address - Street 2:STE 2201
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-0596
Mailing Address - Country:US
Mailing Address - Phone:239-631-1960
Mailing Address - Fax:239-631-5967
Practice Address - Street 1:1875 VETERANS PARK DR STE 2201
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-0596
Practice Address - Country:US
Practice Address - Phone:239-631-1960
Practice Address - Fax:239-631-5967
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA46655208100000X
NY164348208100000X
FLME1314422081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0878110001Medicare NSC
CAD91943Medicare UPIN
CAW268Medicare PIN
CAWA46655AMedicare PIN
CAW268EMedicare PIN
NYA400124199Medicare PIN
CAW268AMedicare PIN
CAWA46655FMedicare PIN