Provider Demographics
NPI:1588710354
Name:LUGO, PATRIA M (RPH)
Entity type:Individual
Prefix:MRS
First Name:PATRIA
Middle Name:M
Last Name:LUGO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 6 BOX 10400
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627
Mailing Address - Country:US
Mailing Address - Phone:787-820-2148
Mailing Address - Fax:787-820-8181
Practice Address - Street 1:ROAD 119 KM 9.0
Practice Address - Street 2:
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627
Practice Address - Country:US
Practice Address - Phone:787-820-2148
Practice Address - Fax:787-820-8181
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4365183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4365OtherPR PHARMACY BOARD LICENSE