Provider Demographics
NPI:1871073825
Name:RUIZ-LUGO, LUZELIX (PHD)
Entity type:Individual
Prefix:
First Name:LUZELIX
Middle Name:
Last Name:RUIZ-LUGO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB CIUDAD JARDIN
Mailing Address - Street 2:213 CALLE AMAPOLA
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987
Mailing Address - Country:US
Mailing Address - Phone:787-410-2376
Mailing Address - Fax:
Practice Address - Street 1:URB CIUDAD JARDIN
Practice Address - Street 2:213 CALLE AMAPOLA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987
Practice Address - Country:US
Practice Address - Phone:787-410-2376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4633103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical