Provider Demographics
NPI:1578294948
Name:CONTRERAS LUGO, ANGENY
Entity Type:Individual
Prefix:
First Name:ANGENY
Middle Name:
Last Name:CONTRERAS LUGO
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 1:2489 NE 2ND DR
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-6207
Mailing Address - Country:US
Mailing Address - Phone:787-237-2578
Mailing Address - Fax:
Practice Address - Street 1:13501 SW 128TH ST STE 116
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5862
Practice Address - Country:US
Practice Address - Phone:305-235-5592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14066111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor