MEDICARE: DR. DOLLY E. 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
1	183500000X	Pharmacist	4605	PR
2	208M00000X	Hospitalist Physician	19001	PR
3	207Q00000X	Family Medicine Physician	19001	PR

General Provider Information

NPI Number	:	1588877450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOLLY E. LUGO MD

Provider Business Mailing Address
First Line	:	PO BOX 1875
Second Line	:
City	:	BOQUERON
State	:	PR
Zip	:	00622-1875
Country	:	US
Telephone Number	:	939-388-5846
Fax Number	:

Provider Business Practice Location Address
First Line	:	770 AVE HOSTOS STE 306
Second Line	:
City	:	MAYAGUEZ
State	:	PR
Zip	:	00682-1552
Country	:	US
Telephone Number	:	787-834-6160
Fax Number	:	787-805-4635

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

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	10/13/2023

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Directions to “ DR. DOLLY E. LUGO MD” Practice Location

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