Provider Demographics
NPI:1851361323
Name:PAGAN, IRIS ROCIO
Entity Type:Individual
Prefix:
First Name:IRIS
Middle Name:ROCIO
Last Name:PAGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 CALLE VIRGO
Mailing Address - Street 2:VENUS GARDENS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4926
Mailing Address - Country:US
Mailing Address - Phone:787-761-4297
Mailing Address - Fax:
Practice Address - Street 1:1740 CALLE VIRGO
Practice Address - Street 2:VENUS GARDENS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-4926
Practice Address - Country:US
Practice Address - Phone:787-761-4297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2499183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician