Provider Demographics
NPI:1225257058
Name:HERNANDEZ-LUGO, VENUS N (MS)
Entity Type:Individual
Prefix:
First Name:VENUS
Middle Name:N
Last Name:HERNANDEZ-LUGO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CONDOMINIO LAS TORRES SUR,
Mailing Address - Street 2:OFICINA 2-E
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959
Mailing Address - Country:US
Mailing Address - Phone:787-459-9427
Mailing Address - Fax:787-787-2447
Practice Address - Street 1:CONDOMINIO LAS TORRES SUR
Practice Address - Street 2:OFICINA 2-E
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-459-9427
Practice Address - Fax:787-787-2447
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1520103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical