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Individual

MIRTA LUGO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
14254 DR MARTIN LUTHER KING JR BLVD, DOVER, FL 33527-4414
(813) 653-6100
Mailing address
14254 DR MARTIN LUTHER KING JR BLVD, DOVER, FL 33527-4414
(813) 333-8781

Taxonomy

Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
9193993
FL
363LC1500X
Community Health Nurse Practitioner
Primary
APRN11021969
FL

Other

Enumeration date
09/07/2022
Last updated
12/22/2025
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