Provider Demographics
NPI:1447737770
Name:LUGO, JUAN ESTEBAN III (DC, LAC)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:ESTEBAN
Last Name:LUGO
Suffix:III
Gender:M
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 CALLE ZARAGOZA
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730-4022
Mailing Address - Country:US
Mailing Address - Phone:787-400-1081
Mailing Address - Fax:
Practice Address - Street 1:CALLE NUBE 10, URB BELLA VISTA
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716
Practice Address - Country:US
Practice Address - Phone:787-400-1081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011486111N00000X
PR718111N00000X
PAAK001304171100000X
NY013064111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist