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NPI Code Detail

MEDICARE: DR. ENRIQUE RAFAEL MARTINEZ LUGO MD

MEDICARE: DR. ENRIQUE RAFAEL MARTINEZ LUGO 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
1208D00000XGeneral Practice PhysicianACN1073FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083819361
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ENRIQUE RAFAEL MARTINEZ LUGO MD
Provider Business Mailing Address
First Line : PO BOX 878
Second Line :
City : DAVENPORT
State : FL
Zip : 33836-0878
Country : US
Telephone Number : 689-223-3898
Fax Number : 689-223-3898
Provider Business Practice Location Address
First Line : 106 PARK PLACE BLVD STE C
Second Line :
City : DAVENPORT
State : FL
Zip : 33837-6868
Country : US
Telephone Number : 863-588-4775
Fax Number : 863-422-7664
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2007
Last Update Date : 12/16/2025

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