| Doctor Name: | DR. CARLOS MANUEL GONZALEZ PAGAN |
| NPI Number: | 1396976015 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 17679 |
| Business Practice Address: | Ave General Valero # 375 Esquina Medica Suite 103 Fajardo, PR - 007383949 |
| Business Phone Number: | 7878603674 |
| Business Fax Number: | 7878015757 |
| Mailing Address: | C41 Calle 4, Urb. Villa Alba SABANA GRANDE |
| State: | PR |
| Postal Code: | 006371774 |
| Phone Number: | 7872377066 |
| Fax Number: | 7878015757 |
| NPI Enumeration Date: | 07/29/2009 |
| NPI Last Update Date: | 02/22/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 17679 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |