Provider Demographics
NPI:1831425743
Name:PAGAN, JOHANNA (MD)
Entity type:Individual
Prefix:DR
First Name:JOHANNA
Middle Name:
Last Name: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:G.E.S.
Mailing Address - Street 2:3ER PISO EDF JESUS T. PINERO AVE. FERNANDEZ JUNCOS ESQ.
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985
Mailing Address - Country:US
Mailing Address - Phone:787-284-3737
Mailing Address - Fax:787-284-3700
Practice Address - Street 1:CALLE CENA FINAL 900 PARADA 15
Practice Address - Street 2:LA TORRE DE PLAZA SUITE 614
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-0000
Practice Address - Country:US
Practice Address - Phone:787-768-1365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-28
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17735208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice