Basic Information
| Provider Information | |||||||||
| NPI: | 1427520865 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARROYO PAGAN | ||||||||
| FirstName: | IDA | ||||||||
| MiddleName: | PAULIZA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1077 | ||||||||
| Address2: | |||||||||
| City: | AIBONITO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007051077 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7874028090 | ||||||||
| FaxNumber: | 7877354887 | ||||||||
| Practice Location | |||||||||
| Address1: | 156 CALLE BALDORIOTY N | ||||||||
| Address2: | |||||||||
| City: | AIBONITO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007053218 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877354887 | ||||||||
| FaxNumber: | 7877354887 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/26/2018 | ||||||||
| LastUpdateDate: | 12/26/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 21159 | PR | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.