Healthcare Provider Details

I. General information

NPI: 1497322457
Provider Name (Legal Business Name): EDWIN PAGAN JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2021
Last Update Date: 06/07/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 N KENDALL DR
MIAMI FL
33176-2118
US

IV. Provider business mailing address

8900 N KENDALL DR ATTN: MARY CARPINTERO
MIAMI FL
33176-2118
US

V. Phone/Fax

Practice location:
  • Phone: 305-348-0570
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberME181583
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: