Provider Demographics
NPI:1467598813
Name:PAGAN, ALEJANDRA (OTR)
Entity Type:Individual
Prefix:MRS
First Name:ALEJANDRA
Middle Name:
Last Name:PAGAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 DELLA CT
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:FL
Mailing Address - Zip Code:34465-3700
Mailing Address - Country:US
Mailing Address - Phone:352-746-9869
Mailing Address - Fax:
Practice Address - Street 1:538 N LECANTO HWY
Practice Address - Street 2:SUITE 538
Practice Address - City:LECANTO
Practice Address - State:FL
Practice Address - Zip Code:34461-8547
Practice Address - Country:US
Practice Address - Phone:352-746-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT12488225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist