Provider Demographics
NPI:1265409452
Name:PAGAN, DESIREE (MD,FAAP)
Entity type:Individual
Prefix:DR
First Name:DESIREE
Middle Name:
Last Name:PAGAN
Suffix:
Gender:F
Credentials:MD,FAAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ASHFORD MEDICAL CTR
Mailing Address - Street 2:29 WASHINGTON ST, STE 703
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-1510
Mailing Address - Country:US
Mailing Address - Phone:787-725-9708
Mailing Address - Fax:787-725-2575
Practice Address - Street 1:ASHFORD MEDICAL CTR
Practice Address - Street 2:29 WASHINGTON ST, STE 703
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-1510
Practice Address - Country:US
Practice Address - Phone:787-725-9708
Practice Address - Fax:787-725-2575
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6440208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics