Provider Demographics
NPI:1487548780
Name:LUGO MARTINEZ, AGNES MARIELLA (PHARMD)
Entity type:Individual
Prefix:
First Name:AGNES
Middle Name:MARIELLA
Last Name:LUGO MARTINEZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. QUINTAS DE CABO ROJO
Mailing Address - Street 2:CALLE PICAFLOR 192
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623
Mailing Address - Country:US
Mailing Address - Phone:787-212-8397
Mailing Address - Fax:
Practice Address - Street 1:URB. QUINTAS DE CABO ROJO
Practice Address - Street 2:CALLE PICAFLOR 192
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623
Practice Address - Country:US
Practice Address - Phone:787-212-8397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR66050601835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist