Healthcare Provider Details

I. General information

NPI: 1306789219
Provider Name (Legal Business Name): CARLOS JAVIER PAGAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 AVE LAUREL
BAYAMON PR
00956-4816
US

IV. Provider business mailing address

URB PUERTO NUEVO CALLE CAMPINA 1212
SAN JUAN PR
00920
US

V. Phone/Fax

Practice location:
  • Phone: 787-787-5151
  • Fax:
Mailing address:
  • Phone: 939-940-3542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number17-541-I
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: