Healthcare Provider Details

I. General information

NPI: 1144367376
Provider Name (Legal Business Name): CARMEN I LUGO RAMIREZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 04/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 349 KM 2.7 CERRO LAS MESAS
MAYAGUEZ PR
00680
US

IV. Provider business mailing address

PO BOX 662
MAYAGUEZ PR
00681-0662
US

V. Phone/Fax

Practice location:
  • Phone: 787-834-2350
  • Fax: 787-891-0172
Mailing address:
  • Phone: 787-674-3540
  • Fax: 787-891-0172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number15695
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: