Healthcare Provider Details

I. General information

NPI: 1750567558
Provider Name (Legal Business Name): FRANCISCO LUGO DPM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2008
Last Update Date: 06/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8555 16TH ST
SILVER SPRING MD
20910-2816
US

IV. Provider business mailing address

1201 GOTH LN
SILVER SPRING MD
20905-5519
US

V. Phone/Fax

Practice location:
  • Phone: 301-588-4811
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number01067
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. FRANCISCO LUGO
Title or Position: PHYSICIAN
Credential: DPM
Phone: 301-588-4811