Provider Demographics
NPI:1467770487
Name:LUGO, ISRAEL JR (TEM)
Entity Type:Individual
Prefix:MR
First Name:ISRAEL
Middle Name:
Last Name:LUGO
Suffix:JR
Gender:M
Credentials:TEM
Other - Prefix:MR
Other - First Name:ISRAEL
Other - Middle Name:
Other - Last Name:LUGO
Other - Suffix:JR
Other - Last Name Type:Former Name
Other - Credentials:TEM
Mailing Address - Street 1:COM LAS MARIAS 455 CALLE LUIS MUNOZ MARIN
Mailing Address - Street 2:RR 2 BOX 3358
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610
Mailing Address - Country:US
Mailing Address - Phone:787-988-9793
Mailing Address - Fax:
Practice Address - Street 1:COM LAS MARIAS 455 CALLE LUIS MUNOZ MARIN
Practice Address - Street 2:RR 2 BOX 3358
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610
Practice Address - Country:US
Practice Address - Phone:787-988-9793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-14
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRPP146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic