Provider Demographics
NPI:1265095715
Name:LUGO, YAKELIN (HHA)
Entity type:Individual
Prefix:
First Name:YAKELIN
Middle Name:
Last Name:LUGO
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2312 W DEWEY ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-1312
Mailing Address - Country:US
Mailing Address - Phone:813-793-1577
Mailing Address - Fax:
Practice Address - Street 1:2312 W DEWEY ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-1312
Practice Address - Country:US
Practice Address - Phone:813-793-1577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-19
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide