Provider Demographics
NPI:1154365385
Name:LUGO ARVELO, WALDEMAR (DC)
Entity type:Individual
Prefix:DR
First Name:WALDEMAR
Middle Name:
Last Name:LUGO ARVELO
Suffix:
Gender:M
Credentials:DC
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 2017
Mailing Address - Street 2:PMB 627
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00771-2017
Mailing Address - Country:US
Mailing Address - Phone:787-733-7430
Mailing Address - Fax:787-733-2579
Practice Address - Street 1:CARR 183 KM 18.6
Practice Address - Street 2:BASE 3 LOTE 3 BO. MONTONES
Practice Address - City:LAS PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00771
Practice Address - Country:US
Practice Address - Phone:787-733-7430
Practice Address - Fax:787-733-2579
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR369111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor