Individual provider Active NPI

Lourdes Rebecca Rosario Lugo, MD

  • General Practice Physician
  • Kissimmee, FL
National Provider Identifier
1346266301
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN1104 Issued in FL
Practice address
3195 Retreat Dr Apt 103
Kissimmee, FL 34741-7895
Phone
(656) 217-0802
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ACN1104 FL Primary
Internal Medicine Physician 207R00000X 11298 PR

Addresses

Primary practice location

3195 Retreat Dr Apt 103
Kissimmee, FL 34741-7895

Mailing address

3195 Retreat Dr Apt 103
Kissimmee, FL 34741-7895
Phone (656) 217-0802

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170617000052 PR Practitioner - Internal Medicine 5395013270 Reassigns benefits to 1 organization
I20191022001624 FL Practitioner - General Practice 5395013270 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2306 N Blvd W
Suite C
Davenport, FL 33837-8976
Phone (863) 866-9000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11298PRMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Olympia Medical Group, LLC CurrentSince May 25, 2025 Accepting new patients
Lions Family Care LLC General Practice CurrentSince Dec 1, 2025 Accepting new patients
Centro Medico del Turabo Inc CurrentSince Apr 10, 2017 Accepting new patients
Serenity Life Counseling Center LLC CurrentSince Oct 1, 2025 Accepting new patients
Centro Medico del Turabo Inc General Practice CurrentSince Apr 10, 2017 Accepting new patients
Southern Health Care Group, Inc. Internal Medicine PastSince Oct 20, 2019 Accepting new patients
Puerto Rico Health Care Group Internal Medicine Past Accepting new patients

Locations

2306 North Blvd W
Ste C
Davenport, FL 33837
Phone (863) 547-9200

804 N Hoagland Blvd
Kissimmee, FL 34741
Phone (407) 797-7298

11251 S Orange Blossom Trl
Ste 102
Orlando, FL 32837
Phone (407) 237-0079

100 Ave Luis Munoz Marin
Caguas, PR 00725
Phone (787) 423-2261

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1346266301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3195 RETREAT DR APT 103",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347417895",
            "telephone_number": "656-217-0802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3195 RETREAT DR APT 103",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347417895",
            "telephone_number": "656-217-0802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSARIO LUGO",
        "first_name": "LOURDES",
        "middle_name": "REBECCA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN1104",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "11298",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.