Provider Demographics
NPI:1750311197
Name:SANTIAGO-LUGO, RUBEN JESUS (MD)
Entity Type:Individual
Prefix:DR
First Name:RUBEN
Middle Name:JESUS
Last Name:SANTIAGO-LUGO
Suffix:
Gender:M
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:PO BOX 65
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-0065
Mailing Address - Country:US
Mailing Address - Phone:787-786-1669
Mailing Address - Fax:787-786-2296
Practice Address - Street 1:18
Practice Address - Street 2:DD4 ALTURAS DE FLAMBOYAN
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-786-1669
Practice Address - Fax:787-786-2296
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10246207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine