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NPI Code Detail

MEDICARE: BRENDA MARANGEL DE JESUS PAGAN MD

MEDICARE: BRENDA MARANGEL DE JESUS PAGAN MD
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
1208000000XPediatrics Physician13619PR
2208000000XPediatrics PhysicianME142282FL

General Provider Information

NPI Number : 1427071760
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDA MARANGEL DE JESUS PAGAN MD
Provider Business Mailing Address
First Line : 10268 SW CAPTIVA DR
Second Line :
City : PORT ST LUCIE
State : FL
Zip : 34987-6402
Country : US
Telephone Number : 787-462-1542
Fax Number :
Provider Business Practice Location Address
First Line : 714 AVENUE C
Second Line :
City : FORT PIERCE
State : FL
Zip : 34950-4189
Country : US
Telephone Number : 772-429-3400
Fax Number : 772-252-7116
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2006
Last Update Date : 04/16/2025

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