Provider Demographics
NPI:1770134405
Name:LUGO-RUIZ, SONILYN (MD)
Entity type:Individual
Prefix:DR
First Name:SONILYN
Middle Name:
Last Name:LUGO-RUIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 CALLE ASTARTE
Mailing Address - Street 2:ALTO APOLO
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-4943
Mailing Address - Country:US
Mailing Address - Phone:787-472-9011
Mailing Address - Fax:
Practice Address - Street 1:120 DOMENECH AVENUE
Practice Address - Street 2:BALDRICH
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3500
Practice Address - Country:US
Practice Address - Phone:787-472-9011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-24
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR215422083P0500X, 2083X0100X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine