Healthcare Provider Details

I. General information

NPI: 1356437834
Provider Name (Legal Business Name): FERDINAND LUGO ROMEU D.M.D., M.SC.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 AVE FD ROOSEVELT SUITE 615 LA TORRE DE PLAZA
SAN JUAN PR
00918-8001
US

IV. Provider business mailing address

525 AVE FD ROOSEVELT SUITE 615 LA TORRE DE PLAZA
SAN JUAN PR
00918-8001
US

V. Phone/Fax

Practice location:
  • Phone: 787-767-1233
  • Fax: 787-753-0299
Mailing address:
  • Phone: 787-767-1233
  • Fax: 787-753-0299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number842
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: