Provider Demographics
NPI:1114027976
Name:LUGO-LUGO, PEDRO
Entity type:Individual
Prefix:MR
First Name:PEDRO
Middle Name:
Last Name:LUGO-LUGO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:LUGO
Other - Middle Name:AMBULANCE
Other - Last Name:SERVICE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:RR 3 BOX 10807
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610-9651
Mailing Address - Country:US
Mailing Address - Phone:787-826-2525
Mailing Address - Fax:787-551-7104
Practice Address - Street 1:ROAD 109 KM 5.3
Practice Address - Street 2:BO ESPINO
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610-0000
Practice Address - Country:US
Practice Address - Phone:787-826-2525
Practice Address - Fax:787-551-7104
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTC AMB 4243416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR50740OtherPMC
PR69277OtherAMERICAN HEALTH MEDICARE
PR69277OtherAMERICAN HEALTH MEDICARE