Provider Demographics
NPI:1124816988
Name:LUGO, DARIA MICHELLE
Entity type:Individual
Prefix:
First Name:DARIA
Middle Name:MICHELLE
Last Name:LUGO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 W PERSHING RD STE 403
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-4305
Mailing Address - Country:US
Mailing Address - Phone:785-429-4767
Mailing Address - Fax:816-207-0639
Practice Address - Street 1:215 W PERSHING RD STE 403
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-4305
Practice Address - Country:US
Practice Address - Phone:785-429-4767
Practice Address - Fax:816-207-0639
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-30
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No174400000XOther Service ProvidersSpecialist
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter