Provider Demographics
NPI:1871587873
Name:LUGO, NILMA E (MPT, PT)
Entity type:Individual
Prefix:MS
First Name:NILMA
Middle Name:E
Last Name:LUGO
Suffix:
Gender:F
Credentials:MPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1892
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00977-1892
Mailing Address - Country:US
Mailing Address - Phone:787-283-2170
Mailing Address - Fax:787-283-2170
Practice Address - Street 1:CARR 876 KM. 4.0
Practice Address - Street 2:BO LAS CUEVAS
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976
Practice Address - Country:US
Practice Address - Phone:787-283-2170
Practice Address - Fax:787-283-2170
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-06
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR303225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR223182OtherPREFERRED HEALTH
PR89967LUOtherSSS
PRX0019OtherLA CRUZ AZUL
PR3040-5OtherPROSAM
PR9760052OtherHUMANA INS & HEALTH PLAN
PR870059OtherMEDICARE Y MUCHO MAS
PRX0019OtherLA CRUZ AZUL