MEDICARE: DR. ESTEBAN MARTINEZ LUGO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	10455	PR

General Provider Information

NPI Number	:	1043209083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ESTEBAN MARTINEZ LUGO

Provider Business Mailing Address
First Line	:	PO BOX 6400
Second Line	:	PMB 380
City	:	CAYEY
State	:	PR
Zip	:	00737-6400
Country	:	US
Telephone Number	:	787-738-1390
Fax Number	:

Provider Business Practice Location Address
First Line	:	CALLE SAN RAFAEL 1395
Second Line	:	DOCTOR CENTER HOSPITAL
City	:	SANTURCE
State	:	PR
Zip	:	00910-3428
Country	:	US
Telephone Number	:	787-999-7620
Fax Number	:	787-725-2124

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2005
Last Update Date	:	11/11/2010

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