Provider Demographics
NPI:1104054899
Name:ROSA-LUGO, LINDA IRIS (EDD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:IRIS
Last Name:ROSA-LUGO
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2960 COTTAGE GROVE CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-4308
Mailing Address - Country:US
Mailing Address - Phone:407-207-1192
Mailing Address - Fax:407-823-4816
Practice Address - Street 1:12424 RESEARCH PKWY
Practice Address - Street 2:155
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32826-3249
Practice Address - Country:US
Practice Address - Phone:407-882-0468
Practice Address - Fax:407-249-4774
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-01
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 3064235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist