MEDICARE: IRIS ROCIO PAGAN

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	183700000X	Pharmacy Technician	2499	PR

General Provider Information

NPI Number	:	1851361323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRIS ROCIO PAGAN

Provider Business Mailing Address
First Line	:	1740 CALLE VIRGO
Second Line	:	VENUS GARDENS
City	:	SAN JUAN
State	:	PR
Zip	:	00926-4926
Country	:	US
Telephone Number	:	787-761-4297
Fax Number	:

Provider Business Practice Location Address
First Line	:	1740 CALLE VIRGO
Second Line	:	VENUS GARDENS
City	:	SAN JUAN
State	:	PR
Zip	:	00926-4926
Country	:	US
Telephone Number	:	787-761-4297
Fax Number	:

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

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	07/08/2007

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