Provider Demographics
NPI:1295801298
Name:LUGO MEDICAL SERVICES PSC
Entity type:Organization
Organization Name:LUGO MEDICAL SERVICES PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WALDEMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:LUGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-758-3502
Mailing Address - Street 1:BOX 13312
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00908-3312
Mailing Address - Country:US
Mailing Address - Phone:787-758-3502
Mailing Address - Fax:787-772-4734
Practice Address - Street 1:COND NACIONAL PLAZA SUITE 326
Practice Address - Street 2:PONCE DE LEON 431
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-758-3502
Practice Address - Fax:787-772-4734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty