Provider Demographics
NPI:1508877234
Name:PAGAN, JOSE DOMINGO (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:DOMINGO
Last Name:PAGAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 20483
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00928
Mailing Address - Country:US
Mailing Address - Phone:787-621-3777
Mailing Address - Fax:787-621-3776
Practice Address - Street 1:URB ATENAS CALLE HERNANDEZ CARRION CARRETARA # 2
Practice Address - Street 2:INTERCECCION 668 MANATI MEDICAL CENTER FIRST FLOOR
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-621-3777
Practice Address - Fax:787-621-3776
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2009-12-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR12860208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery