Provider Demographics
NPI:1649312489
Name:PEREZ-PAGAN, IVETTE AMALIA (MD)
Entity type:Individual
Prefix:DR
First Name:IVETTE
Middle Name:AMALIA
Last Name:PEREZ-PAGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:EA4 CALLE ROSA DE TEJAS
Mailing Address - Street 2:URB. LA ROSALEDA
Mailing Address - City:LEVITTOWN
Mailing Address - State:PR
Mailing Address - Zip Code:00949-4721
Mailing Address - Country:US
Mailing Address - Phone:787-607-0893
Mailing Address - Fax:787-720-4412
Practice Address - Street 1:EA4 CALLE ROSA DE TEJAS
Practice Address - Street 2:URB. LA ROSALEDA
Practice Address - City:LEVITTOWN
Practice Address - State:PR
Practice Address - Zip Code:00949-4721
Practice Address - Country:US
Practice Address - Phone:787-607-0893
Practice Address - Fax:787-720-4412
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16526208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice