Individual provider Active NPI

Luis Raimundo Pagan, MD

  • Neurological Surgery Physician
  • Hialeah, FL
National Provider Identifier
1104849686
Registry record updated Jul 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
ME00033362 Issued in FL
Practice address
7100 W 20TH Ave
Suite G-176
Hialeah, FL 33016-1897
Phone
(305) 826-3366
Fax
(305) 826-7973
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X ME00033362 FL Primary

Addresses

Primary practice location

7100 W 20TH Ave
Suite G-176
Hialeah, FL 33016-1897

Mailing address

7100 W 20TH Ave
Suite G-176
Hialeah, FL 33016-1897
Phone (305) 826-3366

Other identifiers 1

IdentifierTypeStateIssuer
042852300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME00033362FLMDNeurological Surgery Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279152000000",
    "number": "1104849686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 W 20TH AVE",
            "address_2": "SUITE G-176",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330161897",
            "telephone_number": "305-826-3366",
            "fax_number": "305-826-7973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 W 20TH AVE",
            "address_2": "SUITE G-176",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330161897",
            "telephone_number": "305-826-3366",
            "fax_number": "305-826-7973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGAN",
        "first_name": "LUIS",
        "middle_name": "RAIMUNDO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2010-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "FL",
            "license": "ME00033362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "042852300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.