MEDICARE: MILITZA PAGAN MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	5862	PR

General Provider Information

NPI Number	:	1538594775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MILITZA PAGAN MSW

Provider Business Mailing Address
First Line	:	205 LES JARDINS
Second Line	:
City	:	TRUJILLO ALTO
State	:	PR
Zip	:	00976-2213
Country	:	US
Telephone Number	:	787-378-0938
Fax Number	:

Provider Business Practice Location Address
First Line	:	205 LES JARDINS
Second Line	:
City	:	TRUJILLO ALTO
State	:	PR
Zip	:	00976-2213
Country	:	US
Telephone Number	:	787-378-0938
Fax Number	:	787-378-0938

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2013
Last Update Date	:	09/06/2013

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