Healthcare Provider Details

I. General information

NPI: 1992612840
Provider Name (Legal Business Name): MORAIMA PAGAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 CALLE CONCORDIA P1
PONCE PR
00730-5832
US

IV. Provider business mailing address

URB HACIENDA ISABEL 120 CALLE PALES
SANTA ISABEL PR
00757-3005
US

V. Phone/Fax

Practice location:
  • Phone: 787-223-6537
  • Fax:
Mailing address:
  • Phone: 787-223-6537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MORAIMA PAGAN LA TORRE
Title or Position: OWNER
Credential: MD
Phone: 787-223-6537