Provider Demographics
NPI:1902199151
Name:RAMIREZ-LUGO, ANGEL LUIS (MS)
Entity Type:Individual
Prefix:MR
First Name:ANGEL
Middle Name:LUIS
Last Name:RAMIREZ-LUGO
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:H15 CALLE 6A
Mailing Address - Street 2:VILLA REAL
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-4532
Mailing Address - Country:US
Mailing Address - Phone:787-855-6168
Mailing Address - Fax:787-855-6168
Practice Address - Street 1:H15 CALLE 6A VILLA REAL
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693
Practice Address - Country:US
Practice Address - Phone:787-855-6168
Practice Address - Fax:787-855-6168
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-20
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1686103T00000X, 103TC2200X, 103TM1800X, 103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities