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Individual

DR. JOSE ANTONIO PAGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
ME0040616
FL
207VG0400X
Gynecology Physician
Primary
ME0040616
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001553500
GROUP MEDICAID
FL
05
067804000
FL
01
1386823243
GROUP NPI
FL
01
260609255
GROUP TAX ID
FL
01
BC538A
GROUP MEDICARE PALM HARBOR
FL
01
BC538G
GROUP MEDICARE NEW PORT RICHEY
FL
Enumeration date
10/04/2006
Last updated
01/10/2017
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