Provider Demographics
NPI:1073866992
Name:LUGO, LUIS A (RRT)
Entity type:Individual
Prefix:MR
First Name:LUIS
Middle Name:A
Last Name:LUGO
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 146
Mailing Address - Street 2:CARR 132 KM 13.2
Mailing Address - City:PENUELAS
Mailing Address - State:PR
Mailing Address - Zip Code:00624-0146
Mailing Address - Country:US
Mailing Address - Phone:787-202-4231
Mailing Address - Fax:
Practice Address - Street 1:VALLE ALTO #39
Practice Address - Street 2:CARR 132 KM 13.2
Practice Address - City:PENUELAS
Practice Address - State:PR
Practice Address - Zip Code:00624-0146
Practice Address - Country:US
Practice Address - Phone:787-202-4231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR309227900000X, 2279C0205X, 2279E1000X, 2279P1006X, 2279P3900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279E1000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredEducational
No227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered
No2279C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredCritical Care
No2279P1006XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary Function Technologist
No2279P3900XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredNeonatal/Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2279Z100XMedicare PIN
PR2279P3900XMedicare PIN
PR225B00000XMedicare PIN
PR2279C0205XMedicare PIN
PR2279P1006XMedicare PIN
PR227900000XMedicare PIN