Provider Demographics
NPI:1730387663
Name:PAGAN, ALMA M LOPEZ (LMT)
Entity type:Individual
Prefix:
First Name:ALMA
Middle Name:M LOPEZ
Last Name:PAGAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5174 MABRY DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112-3668
Mailing Address - Country:US
Mailing Address - Phone:239-207-0162
Mailing Address - Fax:
Practice Address - Street 1:5174 MABRY DR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-3668
Practice Address - Country:US
Practice Address - Phone:239-207-0162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA41081225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist