Individual
DR. CARLOS JAVIER LUGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1960 E OSCEOLA PKWY, KISSIMMEE, FL 34743-8626
(407) 978-6400
(407) 530-4326
Mailing address
7550 FUTURES DR STE 104, ORLANDO, FL 32819-9096
(407) 978-6400
(407) 530-4326
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
14272
PR
208D00000X
General Practice Physician
Primary
ACN452
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006614400
—
FL
01
—
ACN452
MEDICINE DOCTOR LIC
FL
Enumeration date
06/15/2006
Last updated
05/02/2023
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