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General NPI Number Information
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NPI Number | 1316020860
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Entity Type | Individual
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Provider Name | ANAIDA E LUGO M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | ROAD 65 DE INFANTERIA #23B
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City | LAJAS
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State | PR
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Zip | 00667
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Country | US
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Telephone | 787-899-4110
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 600
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City | LAJAS
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State | PR
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Zip | 00667-0600
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Country | US
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Telephone | 787-833-2412
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 4140
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License Number State | PR
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