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NPI Code Detail

MEDICARE: AGADA, LLC

MEDICARE: AGADA, LLC
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 Physician14387PR

General Provider Information

NPI Number : 1942639489
Entity Type Code : Organization
Provider Name (Legal Business Name) : AGADA, LLC
Provider Business Mailing Address
First Line : PO BOX 362352
Second Line :
City : SAN JUAN
State : PR
Zip : 00936-2352
Country : US
Telephone Number : 787-752-6505
Fax Number : 787-752-6505
Provider Business Practice Location Address
First Line : BA-22 AVE. MONSERRATE CALLE TULIPAN
Second Line :
City : CAROLINA
State : PR
Zip : 00983-3309
Country : US
Telephone Number : 787-752-6505
Fax Number : 787-752-6505
Authorized Official
Title or Position : DRA
Name : DR. ADA G PAISAN
Credential : MD
Telephone Number : 787-752-6505
Provider Enumeration Date : 11/05/2013
Last Update Date : 11/05/2013

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Directions to “AGADA, LLC ” Practice Location

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