Provider Demographics
NPI:1265658223
Name:SANTIAGO LUGO, HAYDDEE (MD)
Entity Type:Individual
Prefix:
First Name:HAYDDEE
Middle Name:
Last Name:SANTIAGO 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:LA VILLA GARDENS
Mailing Address - Street 2:26 CARR. 833 APT. AG1210
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00971-9009
Mailing Address - Country:US
Mailing Address - Phone:787-798-5275
Mailing Address - Fax:787-995-2919
Practice Address - Street 1:LA VILLA GARDENS
Practice Address - Street 2:26 CARR. 833 APT. AG1210
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00971-9009
Practice Address - Country:US
Practice Address - Phone:787-798-5275
Practice Address - Fax:787-995-2919
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR51372084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1500116OtherHUMANA
PR1940OtherMEDICARE Y MUCHO MAS
PR2302OtherHUMANA GOLD PLUS
PR26543OtherTRIPLE S
PR2893OtherINTERNATINAL MEDICAL CARD
PR065040OtherCRUZ AZUL
PR065040OtherCRUZ AZUL