Provider Demographics
NPI:1508421538
Name:LUGO-FAGUNDO, CAROLINA ISABEL
Entity Type:Individual
Prefix:
First Name:CAROLINA
Middle Name:ISABEL
Last Name:LUGO-FAGUNDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPARTMENT OF RADIOLOGY
Mailing Address - Street 2:601 N CAROLINE STREET
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21205
Mailing Address - Country:US
Mailing Address - Phone:410-955-6369
Mailing Address - Fax:
Practice Address - Street 1:DEPARTMENT OF RADIOLOGY
Practice Address - Street 2:601 N CAROLINE STREET
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21205
Practice Address - Country:US
Practice Address - Phone:410-955-6369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-06
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program