Healthcare Provider Details

I. General information

NPI: 1497201644
Provider Name (Legal Business Name): DIEGO LUGO I M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2016
Last Update Date: 11/04/2020
Certification Date: 11/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 7TH ST N
NAPLES FL
34102-5754
US

IV. Provider business mailing address

PO BOX 8569
NAPLES FL
34101-8569
US

V. Phone/Fax

Practice location:
  • Phone: 239-624-3997
  • Fax: 239-624-8101
Mailing address:
  • Phone: 239-624-0400
  • Fax: 239-624-0464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME144480
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: