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NPI Code Detail

MEDICARE: DR. DAMACIO PAGAN RODRIGUEZ MD

MEDICARE: DR. DAMACIO PAGAN RODRIGUEZ 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
1208D00000XGeneral Practice PhysicianACN489FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811965890
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAMACIO PAGAN RODRIGUEZ MD
Provider Business Mailing Address
First Line : 931 W OAK ST
Second Line : STE 103
City : KISSIMMEE
State : FL
Zip : 34741-4973
Country : US
Telephone Number : 407-931-0444
Fax Number : 407-962-4446
Provider Business Practice Location Address
First Line : 5249 CONWAY RD
Second Line :
City : ORLANDO
State : FL
Zip : 32812-2202
Country : US
Telephone Number : 407-931-0444
Fax Number : 407-962-4446
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2006
Last Update Date : 01/17/2025

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