Healthcare Provider Details

I. General information

NPI: 1548107675
Provider Name (Legal Business Name): VALENTINA LUGO SR.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8960 NW 97TH AVE APT 206
DORAL FL
33178-2592
US

IV. Provider business mailing address

8960 NW 97TH AVE APT 206
DORAL FL
33178-2592
US

V. Phone/Fax

Practice location:
  • Phone: 786-378-1523
  • Fax:
Mailing address:
  • Phone: 786-378-1523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-518235
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: