Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 5798 | PR |
NPI | 1013912369 |
---|---|
Provider Name | Dr. Albert Vazquez Lugo |
First Address | Spring Lake, NC 28390-7055 |
Second Address | Fayetteville, NC 28304-6162 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2005 |
Last Update Date | 21/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C77510 | (02) | PR |