Individual
MAYRA LIZ LUGO-GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5510 N HESPERIDES ST, TAMPA, FL 33614-5414
(813) 467-6111
Mailing address
5510 N HESPERIDES ST, TAMPA, FL 33614-5414
(813) 467-6111
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
3900
PR
103TC0700X
Clinical Psychologist
Primary
PY11197
FL
Other
Enumeration date
08/04/2011
Last updated
01/26/2024
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