Provider Demographics
NPI:1225023567
Name:LUGO ZAMBRANA, RUBEN (MD)
Entity Type:Individual
Prefix:DR
First Name:RUBEN
Middle Name:
Last Name:LUGO ZAMBRANA
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:PO BOX 268
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-0268
Mailing Address - Country:US
Mailing Address - Phone:787-866-3584
Mailing Address - Fax:787-866-1249
Practice Address - Street 1:A-3 VILLA ROSA III
Practice Address - Street 2:
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784
Practice Address - Country:US
Practice Address - Phone:787-866-3675
Practice Address - Fax:787-866-1249
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-13
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9657207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0081695Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
PRE20574Medicare UPIN