Provider Demographics
NPI:1629062823
Name:PAGAN-MARRERO, HECTOR DOMINGO I (MD)
Entity Type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:DOMINGO
Last Name:PAGAN-MARRERO
Suffix:I
Gender:M
Credentials:MD
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Mailing Address - Street 1:50 AVE LUIS MUNOZ MARIN
Mailing Address - Street 2:SUITE 304
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-3975
Mailing Address - Country:US
Mailing Address - Phone:787-745-1380
Mailing Address - Fax:787-745-0875
Practice Address - Street 1:50 AVE LUIS MUNOZ MARIN
Practice Address - Street 2:QUADRANGLE MEDICAL CENTER SUITE 304
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-3975
Practice Address - Country:US
Practice Address - Phone:787-745-1380
Practice Address - Fax:787-745-0875
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-02
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR10704207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRF76566Medicare UPIN
PR84235Medicare ID - Type Unspecified