Provider Demographics
NPI:1114751070
Name:RODRIGUEZ-PAGAN, DHARMA RAQUEL
Entity type:Individual
Prefix:
First Name:DHARMA
Middle Name:RAQUEL
Last Name:RODRIGUEZ-PAGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 14551
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00916-4551
Mailing Address - Country:US
Mailing Address - Phone:787-513-9661
Mailing Address - Fax:
Practice Address - Street 1:151 CALLE DE LA TANCA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00901-1412
Practice Address - Country:US
Practice Address - Phone:787-725-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-31
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program