MEDICARE: DR. ALICIA ROHENA-PAGAN AUD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	168	PR

General Provider Information

NPI Number	:	1326256819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALICIA ROHENA-PAGAN AUD

Provider Business Mailing Address
First Line	:	PO BOX 191079
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00919-1079
Country	:	US
Telephone Number	:	787-777-3535
Fax Number	:

Provider Business Practice Location Address
First Line	:	CENTRO PEDIATRICO DE SERVICIOS DE HABILITACION - HPU
Second Line	:	CALL BOX 191079
City	:	SAN JUAN
State	:	PR
Zip	:	00919-1079
Country	:	US
Telephone Number	:	787-763-0550
Fax Number	:	787-763-1093

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	10/02/2009

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