Provider Demographics
NPI:1508740499
Name:LUGO LORA, ANGIE PAOLA
Entity type:Individual
Prefix:
First Name:ANGIE
Middle Name:PAOLA
Last Name:LUGO LORA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10239 SW VILLAGE PKWY APT 305
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34987-2364
Mailing Address - Country:US
Mailing Address - Phone:772-380-2228
Mailing Address - Fax:
Practice Address - Street 1:10239 SW VILLAGE PKWY APT 305
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34987-2364
Practice Address - Country:US
Practice Address - Phone:855-832-6727
Practice Address - Fax:772-675-9100
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician