Provider Demographics
NPI:1790076990
Name:FERDINAND LUGO ROMEU, PERIODONTIST, PSC
Entity Type:Organization
Organization Name:FERDINAND LUGO ROMEU, PERIODONTIST, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FERDINAND
Authorized Official - Middle Name:
Authorized Official - Last Name:LUGO ROMEU
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-767-1233
Mailing Address - Street 1:PO BOX 361181
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-1181
Mailing Address - Country:US
Mailing Address - Phone:787-767-1233
Mailing Address - Fax:787-753-0299
Practice Address - Street 1:525 AVE FD ROOSEVELT
Practice Address - Street 2:SUITE 615 LA TORRE DE PLAZA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-8001
Practice Address - Country:US
Practice Address - Phone:787-767-1233
Practice Address - Fax:787-753-0299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-22
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8421223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty