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General NPI Number Information
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NPI Number | 1700226842
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Entity Type | Individual
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Provider Name | LUIS F PAGAN D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/03/2013
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 8015 TURKEY LAKE RD STE 300
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City | ORLANDO
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State | FL
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Zip | 32819-7383
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Country | US
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Telephone | 407-205-0246
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Fax |
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Provider Business Mailing Address
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Address Line | 382 NE 191 ST 'PMB 892335'
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City | MIAMI
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State | FL
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Zip | 33179-3899
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Country | US
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Telephone | 503-806-0025
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D10214
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DE60677367
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | D10214
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DN292525
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License Number State | FL
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