Provider Demographics
NPI:1225095961
Name:RIVERA-LUGO, DENISE (MD)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:RIVERA-LUGO
Suffix:
Gender:F
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 366928
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-6928
Mailing Address - Country:US
Mailing Address - Phone:787-782-7128
Mailing Address - Fax:
Practice Address - Street 1:252 CALLE SAN JORGE
Practice Address - Street 2:SAN JORGE MEDICAL OFFICE BUILDING SUITE 406
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00912-3310
Practice Address - Country:US
Practice Address - Phone:787-726-0990
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR108062080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology