Healthcare Provider Details

I. General information

NPI: 1609807387
Provider Name (Legal Business Name): ALDO ANGELO LOMBARDO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

851 W INDIANTOWN RD
JUPITER FL
33458-7508
US

IV. Provider business mailing address

851 W INDIANTOWN RD
JUPITER FL
33458-7508
US

V. Phone/Fax

Practice location:
  • Phone: 561-747-1232
  • Fax: 561-747-1251
Mailing address:
  • Phone: 561-747-1232
  • Fax: 561-747-1251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberME0071944
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: