Provider Demographics
NPI:1427180777
Name:LUGO SANTIAGO, SORAYA
Entity type:Individual
Prefix:
First Name:SORAYA
Middle Name:
Last Name:LUGO SANTIAGO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:VISION WORLD
Other - Middle Name:
Other - Last Name:EL SENORIAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:8 CALLE BENITO FEIJOO
Mailing Address - Street 2:URB VILLAS DEL ESTE
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6900
Mailing Address - Country:US
Mailing Address - Phone:787-765-4609
Mailing Address - Fax:787-731-5642
Practice Address - Street 1:22 AVE WINSTON CHURCHILL LOCAL E009
Practice Address - Street 2:SENORIAL PLAZA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-6001
Practice Address - Country:US
Practice Address - Phone:787-765-4609
Practice Address - Fax:787-765-4609
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR00000152W00000X
332H00000X, 261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332H00000XSuppliersEyewear Supplier