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Individual

MANUEL ENRIQUE LUGO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
2809 AUTUMN BREEZE WAY, KISSIMMEE, FL 34744-9273
(407) 497-3041
Mailing address
2809 AUTUMN BREEZE WAY, KISSIMMEE, FL 34744-9273

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
363AM0700X
Medical Physician Assistant
Primary
PA9100273
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
113462500
FL
01
PA9100273
FL MEDICAL LICENSE
FL
Enumeration date
09/16/2009
Last updated
10/21/2025
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