Provider Demographics
NPI:1588877450
Name:LUGO, DOLLY E (MD)
Entity type:Individual
Prefix:DR
First Name:DOLLY
Middle Name:E
Last Name:LUGO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:DOLLY
Other - Middle Name:EILEEN
Other - Last Name:LUGO-MARTINEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:PO BOX 1875
Mailing Address - Street 2:
Mailing Address - City:BOQUERON
Mailing Address - State:PR
Mailing Address - Zip Code:00622-1875
Mailing Address - Country:US
Mailing Address - Phone:939-388-5846
Mailing Address - Fax:
Practice Address - Street 1:770 AVE HOSTOS STE 306
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-1552
Practice Address - Country:US
Practice Address - Phone:787-834-6160
Practice Address - Fax:787-805-4635
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4605183500000X
PR19001208M00000X, 207Q00000X, 207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No183500000XPharmacy Service ProvidersPharmacist
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist