Provider Demographics
NPI:1467603027
Name:DE LA TORRE - LUGO, ENEIDA MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:ENEIDA
Middle Name:MARIA
Last Name:DE LA TORRE - LUGO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:AVENIDA 90 PMB SUITE 126
Mailing Address - Street 2:CENTRO DERMATOLOGICO SAN PABLO PSC
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:787-798-2765
Mailing Address - Fax:787-740-1200
Practice Address - Street 1:CALLE SANTA CRUZ #68 TORRE SAN PABLO SUITE 306
Practice Address - Street 2:CENTRO DERMATOLOGICO SAN PABLO PSC
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-798-2765
Practice Address - Fax:787-740-1200
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2021-06-21
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Provider Licenses
StateLicense IDTaxonomies
PR17986207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology