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General NPI Number Information
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NPI Number | 1811965890
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Entity Type | Individual
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Provider Name | DAMACIO PAGAN RODRIGUEZ MD
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Gender | Male
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Dates
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Enumeration Date | 03/08/2006
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 5249 CONWAY RD
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City | ORLANDO
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State | FL
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Zip | 32812-2202
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Country | US
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Telephone | 407-931-0444
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Fax | 407-962-4446
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Provider Business Mailing Address
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Address Line | 931 W OAK ST STE 103
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City | KISSIMMEE
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State | FL
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Zip | 34741-4973
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Country | US
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Telephone | 407-931-0444
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Fax | 407-962-4446
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ACN489
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License Number State | FL
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