Healthcare Provider Details

I. General information

NPI: 1760478549
Provider Name (Legal Business Name): SAN PABLO DEVELOPERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

STREET 70 EDIFICIO DR. ARTURO CADILLA SUITE 102
BAYAMON PR
00957
US

IV. Provider business mailing address

PO BOX 1186
BAYAMON PR
00960-1186
US

V. Phone/Fax

Practice location:
  • Phone: 787-269-2442
  • Fax: 787-785-9558
Mailing address:
  • Phone: 787-269-2442
  • Fax: 787-785-9558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085D0003X
TaxonomyDiagnostic Neuroimaging (Radiology) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number2
License Number StatePR

VIII. Authorized Official

Name: JUAN M PAGAN
Title or Position: ADMINISTRATOR
Credential: MHSA
Phone: 787-269-2442