Provider Demographics
NPI:1093765091
Name:PAGAN CORTES, LUIS A (MD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:A
Last Name:PAGAN CORTES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. VILLA BORINQUEN
Mailing Address - Street 2:BUZON 372
Mailing Address - City:LARES
Mailing Address - State:PR
Mailing Address - Zip Code:00669-0372
Mailing Address - Country:US
Mailing Address - Phone:787-449-0099
Mailing Address - Fax:787-817-3759
Practice Address - Street 1:URB. VILLA BORINQUEN
Practice Address - Street 2:BUZON 372
Practice Address - City:LARES
Practice Address - State:PR
Practice Address - Zip Code:00669-0372
Practice Address - Country:US
Practice Address - Phone:787-449-0099
Practice Address - Fax:787-817-3759
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15616208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice