Individual
MIGUEL EDUARDO LUGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2925 WYTHE CT, WOODBRIDGE, VA 22191-4637
(787) 518-0361
Mailing address
2925 WYTHE CT, WOODBRIDGE, VA 22191-4637
(787) 518-0361
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10482
AZ
363A00000X
Physician Assistant
—
—
Other
Enumeration date
07/24/2024
Last updated
07/25/2024
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