MEDICARE: DR. JORGE E LUGO-RODRIGUEZ MD

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	207R00000X	Internal Medicine Physician	1919	PR
2	207RC0000X	Cardiovascular Disease Physician	1919	PR

General Provider Information

NPI Number	:	1083608517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JORGE E LUGO-RODRIGUEZ MD

Provider Business Mailing Address
First Line	:	1056 AVE MUNOZ RIVERA
Second Line	:	OFICINA 606
City	:	RIO PIEDRAS
State	:	PR
Zip	:	00927-5015
Country	:	US
Telephone Number	:	787-765-9563
Fax Number	:	787-765-9563

Provider Business Practice Location Address
First Line	:	1056 AVE MUNOZ RIVERA
Second Line	:	OFICINA 606
City	:	RIO PIEDRAS
State	:	PR
Zip	:	00927-5015
Country	:	US
Telephone Number	:	787-765-9563
Fax Number	:	787-765-9563

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

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	03/16/2015

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Directions to “ DR. JORGE E LUGO-RODRIGUEZ MD” Practice Location

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