Provider Demographics
NPI:1194236448
Name:PAGAN-MONTALVO, CRISTINA (BS, MS, PHARMD)
Entity type:Individual
Prefix:DR
First Name:CRISTINA
Middle Name:
Last Name:PAGAN-MONTALVO
Suffix:
Gender:F
Credentials:BS, MS, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2097 AVE HOSTOS
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682-6440
Mailing Address - Country:US
Mailing Address - Phone:787-805-4805
Mailing Address - Fax:787-805-4510
Practice Address - Street 1:2097 AVE HOSTOS
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-6440
Practice Address - Country:US
Practice Address - Phone:787-805-4805
Practice Address - Fax:787-805-4510
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-13
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6480333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy