Provider Demographics
NPI:1245395862
Name:GARCIA LUGO, JOSE A JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:A
Last Name:GARCIA LUGO
Suffix:JR
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 82
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-0082
Mailing Address - Country:US
Mailing Address - Phone:787-525-5435
Mailing Address - Fax:
Practice Address - Street 1:EA06 CALLE ROSA DE TEJAS
Practice Address - Street 2:
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-4721
Practice Address - Country:US
Practice Address - Phone:787-795-5994
Practice Address - Fax:787-795-5994
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15258208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice