Active NPI
Damaris Sepulveda Diaz
- Pharmacist
- Las Piedras, PR
National Provider Identifier
1013415835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5061
- Practice address
- Bo. Montones 1
PR 183 KM 19.3
Las Piedras, PR 00771-1201 - Phone
- (787) 912-7777
- Fax
- (787) 912-7779
- NPI assigned
- Jan 26, 2018
- Reactivated
- Jan 15, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5061 | PR | Primary |
Addresses
Primary practice location
Bo. Montones 1
PR 183 KM 19.3
Las Piedras, PR 00771-1201
Mailing address
P.O. Box 1201
Las Piedras, PR 00771-1201
Phone (787) 912-7777
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5061 | PR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579046400000",
"number": "1013415835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 1201",
"city": "LAS PIEDRAS",
"state": "PR",
"postal_code": "007711201",
"telephone_number": "787-912-7777",
"fax_number": "787-912-7779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BO. MONTONES 1",
"address_2": "PR 183 KM 19.3",
"city": "LAS PIEDRAS",
"state": "PR",
"postal_code": "007711201",
"telephone_number": "787-912-7777",
"fax_number": "787-912-7779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEPULVEDA DIAZ",
"first_name": "DAMARIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-26",
"last_updated": "2020-01-15",
"certification_date": "2020-01-15",
"deactivation_date": "2019-09-30",
"reactivation_date": "2020-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PR",
"license": "5061",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Piedras, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.