Provider Demographics
NPI:1275077760
Name:PAJON-MASJUAN, LUISA MARIA
Entity Type:Individual
Prefix:MISS
First Name:LUISA
Middle Name:MARIA
Last Name:PAJON-MASJUAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3023 NW 63RD ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33147-7639
Mailing Address - Country:US
Mailing Address - Phone:786-762-6988
Mailing Address - Fax:
Practice Address - Street 1:12051 W OKEECHOBEE RD
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-2933
Practice Address - Country:US
Practice Address - Phone:786-762-6988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-19
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician