Provider Demographics
NPI:1578764148
Name:LUGO, LAURA E (RPH)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:E
Last Name:LUGO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 VIA DE LA MONTANA
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-3374
Mailing Address - Country:US
Mailing Address - Phone:787-771-7919
Mailing Address - Fax:787-771-7442
Practice Address - Street 1:318 VIA DE LA MONTANA
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-3374
Practice Address - Country:US
Practice Address - Phone:787-771-7919
Practice Address - Fax:787-771-7442
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4767183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist