Provider Demographics
NPI:1376082776
Name:LUGO, BELINDA (CPHT)
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:
Last Name:LUGO
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 CALLE SUENO DE MAR
Mailing Address - Street 2:URB HACIENDAS DE MIRAMAR
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-9027
Mailing Address - Country:US
Mailing Address - Phone:787-810-0574
Mailing Address - Fax:
Practice Address - Street 1:470 CALLE SUENO DE MAR
Practice Address - Street 2:URB HACIENDAS DE MIRAMAR
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623-9027
Practice Address - Country:US
Practice Address - Phone:787-810-0574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2760183700000X
FL140101565609745183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician