Provider Demographics
NPI:1851968036
Name:LUGO MONTALVO, LILYBETH D (AUD)
Entity Type:Individual
Prefix:
First Name:LILYBETH
Middle Name:D
Last Name:LUGO MONTALVO
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. ESTANCIAS DEL GOLF #504
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730-5762
Mailing Address - Country:US
Mailing Address - Phone:505-316-0075
Mailing Address - Fax:
Practice Address - Street 1:124 CALLE SALVADOR BRAU 154
Practice Address - Street 2:HOSPITAL MUNICIPAL MARIANO RIVERA RAMOS
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-4628
Practice Address - Country:US
Practice Address - Phone:787-705-9060
Practice Address - Fax:787-965-5404
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist