Provider Demographics
NPI:1720055700
Name:PAGAN, HILDA L (AUD)
Entity Type:Individual
Prefix:DR
First Name:HILDA
Middle Name:L
Last Name:PAGAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PLAZA PRADERA STE 20
Mailing Address - Street 2:PMB 103
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949
Mailing Address - Country:US
Mailing Address - Phone:787-288-4140
Mailing Address - Fax:787-288-4125
Practice Address - Street 1:COMERIO AVE DD-8 RIVERVIEW
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-0000
Practice Address - Country:US
Practice Address - Phone:787-288-4140
Practice Address - Fax:787-288-4125
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR513231H00000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR60259OtherBLUE SHIELD PROVIDER NUMB
PR60259OtherBLUE SHIELD PROVIDER NUMB