Provider Demographics
NPI:1336119890
Name:LUGO, IRIS (LCDA)
Entity Type:Individual
Prefix:MRS
First Name:IRIS
Middle Name:
Last Name:LUGO
Suffix:
Gender:F
Credentials:LCDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 CALLE TIBER
Mailing Address - Street 2:RIO PIEDRAS HEIGHTS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-2945
Mailing Address - Country:US
Mailing Address - Phone:787-754-8398
Mailing Address - Fax:
Practice Address - Street 1:1619 CALLE TIBER
Practice Address - Street 2:RIO PIEDRAS HEIGHTS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-2945
Practice Address - Country:US
Practice Address - Phone:787-754-8398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3636183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist