Provider Demographics
NPI:1750268819
Name:LUGO, ISAMYLIS (ATO/L)
Entity type:Individual
Prefix:
First Name:ISAMYLIS
Middle Name:
Last Name:LUGO
Suffix:
Gender:F
Credentials:ATO/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARR. 19 KM 0.6 BARRIO MONACILLOS
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-2124
Mailing Address - Country:US
Mailing Address - Phone:787-783-2226
Mailing Address - Fax:787-783-1325
Practice Address - Street 1:CARR. 19 KM 0.6 BARRIO MONACILLOS
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-2124
Practice Address - Country:US
Practice Address - Phone:787-783-2226
Practice Address - Fax:787-783-1325
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1461224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant