Provider Demographics
NPI:1598052276
Name:PAGAN MORALES, MARIEL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARIEL
Middle Name:
Last Name:PAGAN MORALES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 CARR. #167
Mailing Address - Street 2:PLAZA TROPICAL
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-5554
Mailing Address - Country:US
Mailing Address - Phone:787-395-7480
Mailing Address - Fax:787-395-7482
Practice Address - Street 1:550 CARR 167
Practice Address - Street 2:PLAZA TROPICAL
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-5554
Practice Address - Country:US
Practice Address - Phone:787-395-7480
Practice Address - Fax:787-395-7482
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5447183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist