Provider Demographics
NPI:1215414214
Name:PAGAN-RODRIGUEZ, ALLYSON CHRISTINE (MD)
Entity Type:Individual
Prefix:
First Name:ALLYSON
Middle Name:CHRISTINE
Last Name:PAGAN-RODRIGUEZ
Suffix:
Gender:F
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:PO BOX 365067
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-5067
Mailing Address - Country:US
Mailing Address - Phone:787-243-5216
Mailing Address - Fax:
Practice Address - Street 1:BARRIO MONACILLOS PASEO DR JOSE CELSO BARBOSA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-758-2525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-23
Last Update Date:2021-07-14
Deactivation Date:2021-05-24
Deactivation Code:
Reactivation Date:2021-07-13
Provider Licenses
StateLicense IDTaxonomies
PR22397208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice