Provider Demographics
NPI:1639641574
Name:LUGO, ERIKA DENISE (RRT)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:DENISE
Last Name:LUGO
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3520 MAPLE RIDGE LOOP
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-7627
Mailing Address - Country:US
Mailing Address - Phone:772-226-5059
Mailing Address - Fax:
Practice Address - Street 1:3520 MAPLE RIDGE LOOP
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-7627
Practice Address - Country:US
Practice Address - Phone:407-403-9550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT15502227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRT15502OtherRESPIRATORY THERAPY