Provider Demographics
NPI:1952918179
Name:LUGO MORALES, KAREN (DR, DC, LMT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:LUGO MORALES
Suffix:
Gender:F
Credentials:DR, DC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1394 DUNLAWTON AVE
Mailing Address - Street 2:APARTMENT 505
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127
Mailing Address - Country:US
Mailing Address - Phone:787-635-1440
Mailing Address - Fax:
Practice Address - Street 1:1394 DUNLAWTON AVE
Practice Address - Street 2:APARTMENT 505
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127
Practice Address - Country:US
Practice Address - Phone:787-635-1440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-30
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14649111N00000X
FLMA91956225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No111N00000XChiropractic ProvidersChiropractor