Provider Demographics
NPI:1982470928
Name:RIVERA LUGO, LUZ MARIA I
Entity Type:Individual
Prefix:
First Name:LUZ
Middle Name:MARIA
Last Name:RIVERA LUGO
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB PASEO SOL Y MAR E-2 ESMERALDA STREET
Mailing Address - Street 2:613
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795
Mailing Address - Country:US
Mailing Address - Phone:787-460-2494
Mailing Address - Fax:
Practice Address - Street 1:URB PASEO SOL Y MAR ESMERALDA E-2
Practice Address - Street 2:UR
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795
Practice Address - Country:US
Practice Address - Phone:787-460-2494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR145641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical