MEDICARE: ALEXANDER 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	207N00000X	Dermatology Physician	14095	PR
2	207ND0101X	MOHS-Micrographic Surgery Physician	14095	PR

General Provider Information

NPI Number	:	1750323895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDER LUGO MD

Provider Business Mailing Address
First Line	:	2 PASEO SERENO
Second Line	:	LOS PASEOS
City	:	SAN JUAN
State	:	PR
Zip	:	00926-6469
Country	:	US
Telephone Number	:	787-314-6834
Fax Number	:	787-761-0608

Provider Business Practice Location Address
First Line	:	230 CALLE ELEONOR ROOSEVELT
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00918-3005
Country	:	US
Telephone Number	:	787-274-2244
Fax Number	:	787-754-8822

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	01/08/2014

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Directions to “ ALEXANDER LUGO MD” Practice Location

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