Provider Demographics
NPI:1285602987
Name:LUGO VICENTE, HUMBERTO (MD)
Entity type:Individual
Prefix:DR
First Name:HUMBERTO
Middle Name:
Last Name:LUGO VICENTE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 10426
Mailing Address - Street 2:CAPARRA HEIGHTS STATION
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00922-0426
Mailing Address - Country:US
Mailing Address - Phone:787-786-3495
Mailing Address - Fax:787-720-6103
Practice Address - Street 1:73 CALLE SANTA CRUZ
Practice Address - Street 2:SUITE 309, SANTA CRUZ MEDICAL BLDG.
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6910
Practice Address - Country:US
Practice Address - Phone:787-786-3495
Practice Address - Fax:787-720-6103
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR72142086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery