Healthcare Provider Details

I. General information

NPI: 1720664790
Provider Name (Legal Business Name): PAIN MEDICINE SERVICES OF THE CARIBBEAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2021
Last Update Date: 03/22/2021
Certification Date: 03/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 CALLE GUADALUPE
PONCE PR
00730-3775
US

IV. Provider business mailing address

PO BOX 332122
PONCE PR
00733-2122
US

V. Phone/Fax

Practice location:
  • Phone: 787-650-7272
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: HECTOR FRANCISCO CASIANO PAGAN
Title or Position: CEO
Credential: MD
Phone: 787-299-2998