MEDICARE: ALEXANDER LUGO JANER PSC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207NS0135X	Procedural Dermatology Physician	14095	PR

General Provider Information

NPI Number	:	1841483476
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALEXANDER LUGO JANER PSC

Provider Business Mailing Address
First Line	:	230 CALLE ELEONOR ROOSEVELT
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00918-3005
Country	:	US
Telephone Number	:	787-274-2244
Fax Number	:	787-754-8822

Provider Business Practice Location Address
First Line	:	230 CALLE ELEONOR ROOSEVELT
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00918-3005
Country	:	US
Telephone Number	:	787-274-2244
Fax Number	:	787-754-8822

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ALEXANDER LUGO
Credential	:	M.D.
Telephone Number	:	787-274-2244

Provider Enumeration Date	:	08/27/2007
Last Update Date	:	08/27/2007

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