MEDICARE: DR. ALBIN MARTINEZ LUGO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	11087	PR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	89425	OTHER	PR	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	G79003	OTHER	PR	UPIN

General Provider Information

NPI Number	:	1447392998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALBIN MARTINEZ LUGO MD

Provider Business Mailing Address
First Line	:	POLICLINICA BELLA VISTA 770 AVE. HOSTOS SUITE 204
Second Line	:
City	:	MAYAGUEZ
State	:	PR
Zip	:	00682-1538
Country	:	US
Telephone Number	:	787-832-1950
Fax Number	:	787-832-1950

Provider Business Practice Location Address
First Line	:	770 AVE. HOSTOS POLICLINICA BELLA VISTA SUITE 204
Second Line	:
City	:	MAYAGUEZ
State	:	PR
Zip	:	00682-1538
Country	:	US
Telephone Number	:	787-832-1950
Fax Number	:	787-832-1950

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	12/20/2012

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Directions to “ DR. ALBIN MARTINEZ LUGO MD” Practice Location

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