Provider Demographics
NPI:1396976015
Name:GONZALEZ PAGAN, CARLOS MANUEL (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:MANUEL
Last Name:GONZALEZ PAGAN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:C41 CALLE 4
Mailing Address - Street 2:URB. VILLA ALBA
Mailing Address - City:SABANA GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00637-1774
Mailing Address - Country:US
Mailing Address - Phone:787-237-7066
Mailing Address - Fax:787-801-5757
Practice Address - Street 1:AVE GENERAL VALERO # 375
Practice Address - Street 2:ESQUINA MEDICA SUITE 103
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-3949
Practice Address - Country:US
Practice Address - Phone:787-860-3674
Practice Address - Fax:787-801-5757
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-29
Last Update Date:2012-02-22
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Provider Licenses
StateLicense IDTaxonomies
PR17679208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice