Individual provider Active NPI

Roberto Borrero Lugo, M.D.

  • Internal Medicine Physician
  • South Pasadena, FL
National Provider Identifier
1093164949
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME141140 Issued in FL
Practice address
1615 Pasadena Ave S Ste 350
South Pasadena, FL 33707-4521
Phone
(727) 345-6337
Fax
(727) 347-0403
NPI assigned
Jun 10, 2016
Last updated
Feb 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME141140 FL Primary

Addresses

Primary practice location

1615 Pasadena Ave S Ste 350
South Pasadena, FL 33707-4521

Mailing address

330 3Rd St S Unit 522
St Petersburg, FL 33701-4260
Phone (850) 832-3099

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191010000575 FL Practitioner - Internal Medicine 7810228582 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

1615 Pasadena Ave S
Suite 350
South Pasadena, FL 33707-4521
Phone (727) 345-6337

19531 Cochran Blvd
Port Charlotte, FL 33948-2081
Phone (941) 255-3535

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME141140FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC Internal Medicine CurrentSince Feb 1, 2026 Accepting new patients
Verimed Health Group Pasadena, LLC Internal Medicine CurrentSince Jan 1, 2023 Accepting new patients
Millennium Physician Group LLC CurrentSince Feb 1, 2026 Accepting new patients

Locations

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

1615 Pasadena Ave S
Ste 350
South Pasadena, FL 33707
Phone (727) 345-6337

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: roberto.borrero.lugo.1@9582.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1465516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1093164949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 3RD ST S UNIT 522",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014260",
            "telephone_number": "850-832-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 PASADENA AVE S STE 350",
            "city": "SOUTH PASADENA",
            "state": "FL",
            "postal_code": "337074521",
            "telephone_number": "727-345-6337",
            "fax_number": "727-347-0403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORRERO LUGO",
        "first_name": "ROBERTO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-10",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME141140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Pasadena, FL

Sources for this page

Verify at the official NPI Registry.