Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 11909 | PR |
NPI | 1265425516 |
---|---|
Provider Name | Dr. John M Pagan Padilla |
First Address | San Juan, PR 00918-8001 |
Second Address | San Juan, PR 00918-8001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2005 |
Last Update Date | 10/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F24441 | (02) | PR |