Provider Demographics
NPI:1437449253
Name:LUGO, RICARDO MIGUEL (MD)
Entity Type:Individual
Prefix:
First Name:RICARDO
Middle Name:MIGUEL
Last Name:LUGO
Suffix:
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 1:4230 HARDING PIKE
Mailing Address - Street 2:STE 330
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2018
Mailing Address - Country:US
Mailing Address - Phone:615-269-4545
Mailing Address - Fax:
Practice Address - Street 1:4230 HARDING PIKE
Practice Address - Street 2:STE 330
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2018
Practice Address - Country:US
Practice Address - Phone:615-269-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-13
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT198854207R00000X, 390200000X
TN53116207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program