Provider Demographics
NPI:1033103635
Name:PAGAN, JULIO MERREL (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIO
Middle Name:MERREL
Last Name:PAGAN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:805 CENTURY MEDICAL DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32796-2100
Mailing Address - Country:US
Mailing Address - Phone:321-268-6264
Mailing Address - Fax:321-636-9018
Practice Address - Street 1:5005 PORT ST JOHN PKWY STE 2400
Practice Address - Street 2:PARRISH MEDICAL GROUP
Practice Address - City:PORT ST JOHN
Practice Address - State:FL
Practice Address - Zip Code:32927-4305
Practice Address - Country:US
Practice Address - Phone:321-636-0781
Practice Address - Fax:321-636-9018
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2015-05-08
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Provider Licenses
StateLicense IDTaxonomies
FLME48257207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL280847100Medicaid
FL07184ZMedicare UPIN