Provider Demographics
NPI:1225127111
Name:LUGO-RAMIREZ, DAMARIS A (MPT)
Entity Type:Individual
Prefix:MS
First Name:DAMARIS
Middle Name:A
Last Name:LUGO-RAMIREZ
Suffix:
Gender:F
Credentials:MPT
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 287
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610-0287
Mailing Address - Country:US
Mailing Address - Phone:787-826-3606
Mailing Address - Fax:787-826-3606
Practice Address - Street 1:CARR 402 KM1.2
Practice Address - Street 2:BO MARIAS
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610
Practice Address - Country:US
Practice Address - Phone:787-826-3606
Practice Address - Fax:787-826-3606
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR415225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR84194Medicare ID - Type UnspecifiedMEDICARE