Individual provider Active NPI

Shantell Lugo

  • Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
  • South Miami, FL
National Provider Identifier
1972213791
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromuscular Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081N0008X
License
MA88855 Issued in FL
Practice address
8215 SW 72ND Ave Apt 1318
South Miami, FL 33143-7871
Phone
(786) 992-7036
NPI assigned
Dec 2, 2022
Last updated
Dec 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician 2081N0008X MA88855 FL Primary

Addresses

Primary practice location

8215 SW 72ND Ave Apt 1318
South Miami, FL 33143-7871

Mailing address

8215 SW 72ND Ave Apt 1318
South Miami, FL 33143-7871
Phone (786) 992-7036

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA88855FLMDNeuromuscular Medicine (Physical Medicine & Rehabilitation) Physician

NPI Registry JSON

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

{
    "created_epoch": "1669939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1972213791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8215 SW 72ND AVE APT 1318",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331437871",
            "telephone_number": "786-992-7036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8215 SW 72ND AVE APT 1318",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331437871",
            "telephone_number": "786-992-7036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUGO",
        "first_name": "SHANTELL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-02",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081N0008X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Neuromuscular Medicine",
            "state": "FL",
            "license": "MA88855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.