Basic Information
| Provider Information | |||||||||
| NPI: | 1265726905 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALBUQUERQUE | ||||||||
| FirstName: | ROMULO | ||||||||
| MiddleName: | JC | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 110 CONN TER STE 550 | ||||||||
| Address2: | |||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405083206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8593235867 | ||||||||
| FaxNumber: | 8593231122 | ||||||||
| Practice Location | |||||||||
| Address1: | UNIVERSITY OF KENTUCKY & AFFILIATES | ||||||||
| Address2: | 800 ROSE ST. | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405360001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592571363 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2011 | ||||||||
| LastUpdateDate: | 11/28/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | R2686 | KY | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207WX0108X | 48208 | KY | N | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207WX0107X | 48208 | KY | Y |
No ID Information.