MEDICARE: EVA LAGO

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	174400000X	Specialist

General Provider Information

NPI Number	:	1427029255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVA LAGO

Provider Business Mailing Address
First Line	:	BOX 9020458
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00902-0458
Country	:	US
Telephone Number	:	787-258-2835
Fax Number	:

Provider Business Practice Location Address
First Line	:	CALLE DEL PARQUE 240
Second Line	:
City	:	SANTURCE
State	:	PR
Zip	:	00907-0458
Country	:	US
Telephone Number	:	787-258-2835
Fax Number	:

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

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	01/11/2026

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Directions to “ EVA LAGO ” Practice Location

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