Provider Demographics
NPI:1487964888
Name:LUGO-MORALES, YASMIN (CLINICAL PSYCHOLOGIS)
Entity type:Individual
Prefix:DR
First Name:YASMIN
Middle Name:
Last Name:LUGO-MORALES
Suffix:
Gender:F
Credentials:CLINICAL PSYCHOLOGIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S ASHLEY DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-5304
Mailing Address - Country:US
Mailing Address - Phone:407-580-7220
Mailing Address - Fax:
Practice Address - Street 1:13920 LANDSTAR BLVD STE 48
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32824-5524
Practice Address - Country:US
Practice Address - Phone:407-321-0699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-19
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1813103TC0700X
FL10865103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical