Provider Demographics
NPI:1518916295
Name:PAGAN DURAN, CARMEN YOLANDA (MD)
Entity Type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:YOLANDA
Last Name:PAGAN DURAN
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:CALLE ALELI NUM. 166
Mailing Address - Street 2:URB. SAN FRANCISCO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927
Mailing Address - Country:US
Mailing Address - Phone:787-281-0231
Mailing Address - Fax:787-281-0124
Practice Address - Street 1:CALLE ALELI NUM. 166
Practice Address - Street 2:URB. SAN FRANCISCO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927
Practice Address - Country:US
Practice Address - Phone:787-281-0231
Practice Address - Fax:787-281-0124
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA11737000207RR0500X, 207R00000X
PR12554146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR22392Medicare ID - Type Unspecified
PRI13564Medicare UPIN