Provider Demographics
NPI:1497783542
Name:LUGO-CALZADA, LISETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:LISETTE
Middle Name:
Last Name:LUGO-CALZADA
Suffix:
Gender:F
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:PEDIATRIA GENERAL, RCM
Mailing Address - Street 2:PO BOX 29134
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929-0134
Mailing Address - Country:US
Mailing Address - Phone:787-756-4020
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY PEDIATRIC HOSPITAL
Practice Address - Street 2:DEPARTMENT OF PEDIATRICS OFFICE 1-A 29 1ST FLOOR
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936-5067
Practice Address - Country:US
Practice Address - Phone:787-756-4010
Practice Address - Fax:787-777-3227
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9577208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics