Provider Demographics
NPI:1447392998
Name:MARTINEZ LUGO, ALBIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBIN
Middle Name:
Last Name:MARTINEZ LUGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ALBIN
Other - Middle Name:
Other - Last Name:MARTINEZ LUGO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:POLICLINICA BELLA VISTA 770 AVE. HOSTOS SUITE 204
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682-1538
Mailing Address - Country:US
Mailing Address - Phone:787-832-1950
Mailing Address - Fax:787-832-1950
Practice Address - Street 1:770 AVE. HOSTOS POLICLINICA BELLA VISTA SUITE 204
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-1538
Practice Address - Country:US
Practice Address - Phone:787-832-1950
Practice Address - Fax:787-832-1950
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11087207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR89425OtherMEDICARE
PRG79003OtherUPIN