MEDICARE: DR. FAUSTO CARLOS LUGO MORALES 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	208D00000X	General Practice Physician	22093	PR

General Provider Information

NPI Number	:	1093292195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FAUSTO CARLOS LUGO MORALES MD

Provider Business Mailing Address
First Line	:	45 CALLE JASPER
Second Line	:
City	:	VEGA ALTA
State	:	PR
Zip	:	00692-8919
Country	:	US
Telephone Number	:	787-626-3125
Fax Number	:	787-336-0600

Provider Business Practice Location Address
First Line	:	20 CARR 696
Second Line	:
City	:	DORADO
State	:	PR
Zip	:	00646-5767
Country	:	US
Telephone Number	:	787-626-3125
Fax Number	:	787-336-0600

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

Provider Enumeration Date	:	07/23/2018
Last Update Date	:	01/27/2026

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