Healthcare Provider Details

I. General information

NPI: 1669446928
Provider Name (Legal Business Name): FELIX DAVID LUGO-ADAMS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 01/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1452 AVE FERNANDEZ JUNCOS
SAN JUAN PR
00909-2655
US

IV. Provider business mailing address

URB. MARIANI #7519 CALLE DR LOPEZ NUSSA
PONCE PR
00717-0238
US

V. Phone/Fax

Practice location:
  • Phone: 787-470-7171
  • Fax: 787-722-2374
Mailing address:
  • Phone: 787-948-2232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number13917
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number13917
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number13917
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: