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NPI Code Detail

MEDICARE: DR. PRISCILLE M JOGLAR PAGAN PSYD

MEDICARE: DR. PRISCILLE M JOGLAR PAGAN PSYD
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
1103T00000XPsychologist
2103TC0700XClinical Psychologist2553PR

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 : 1861469140
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PRISCILLE M JOGLAR PAGAN PSYD
Provider Business Mailing Address
First Line : PO BOX 9022917
Second Line :
City : SAN JUAN
State : PR
Zip : 00902-2917
Country : US
Telephone Number : 939-218-7262
Fax Number :
Provider Business Practice Location Address
First Line : 725 N 12TH AVE BLDG B
Second Line :
City : ARCADIA
State : FL
Zip : 34266-8752
Country : US
Telephone Number : 863-494-1242
Fax Number : 863-491-0466
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2006
Last Update Date : 05/27/2021

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