Provider Demographics
NPI:1356870745
Name:LUGO DIAZ, GHIARA ALEXANDRA (MD, FACOG)
Entity type:Individual
Prefix:
First Name:GHIARA
Middle Name:ALEXANDRA
Last Name:LUGO DIAZ
Suffix:
Gender:
Credentials:MD, FACOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF PUERTO RICO, MEDICAL SCIENCES CAMPUS
Mailing Address - Street 2:PASEO DR. JOSE CELSO BARBOSA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:HOSPITAL UNIVERSITARIO
Practice Address - Street 2:CENTRO MEDICO DE PUERTO RICO BARRIO MONACILLOS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-754-0101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23322207V00000X
GA95486207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology