Basic Information
Provider Information
NPI: 1437509346
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LUGO LOPEZ
FirstName: ZAHIRA
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 360947
Address2:  
City: SAN JUAN
State: PR
PostalCode: 009360947
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 917 AVE TITO CASTRO
Address2:  
City: PONCE
State: PR
PostalCode: 007164717
CountryCode: US
TelephoneNumber: 7878442080
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/21/2016
LastUpdateDate: 07/04/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/04/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RE0101X21371PRY Allopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism

No ID Information.


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