Provider Demographics
NPI:1134272628
Name:PAGAN, MARIA ROSARIO (APNC)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ROSARIO
Last Name:PAGAN
Suffix:
Gender:F
Credentials:APNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 OAKLEY SEAVER DR
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-1968
Mailing Address - Country:US
Mailing Address - Phone:609-703-0784
Mailing Address - Fax:
Practice Address - Street 1:821 OAKLEY SEAVER DR
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-1968
Practice Address - Country:US
Practice Address - Phone:352-242-1665
Practice Address - Fax:352-243-1649
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO10472200363L00000X
FLAPRN11023455363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ085132AUBMedicare ID - Type Unspecified