Healthcare Provider Details

I. General information

NPI: 1356270839
Provider Name (Legal Business Name): DORADO MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 CARR 696
DORADO PR
00646-5767
US

IV. Provider business mailing address

20 CARR 696
DORADO PR
00646-5767
US

V. Phone/Fax

Practice location:
  • Phone: 787-626-3125
  • Fax: 787-336-0600
Mailing address:
  • Phone: 787-626-3125
  • Fax: 787-336-0600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. FAUSTO C LUGO
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 787-626-3125