Individual
MIRTA M RODRIGUEZ-LUGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2929 COORS BLVD NW, ALBUQUERQUE, NM 87120-1173
(505) 839-2300
(505) 839-2303
Mailing address
PO BOX 26028, ALBUQUERQUE, NM 87125-6028
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD2009-0452
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16401280
—
NM
01
—
NM302536
MEDICARE
NM
Enumeration date
02/21/2008
Last updated
09/30/2024
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