Individual provider Active NPI

Ana Ivelisse Martinez de Andino, PHARMACIST

  • Pharmacist
  • San Juan, PR
National Provider Identifier
1033799952
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2929 Issued in PR
Practice address
733 Ave de Diego
San Juan, PR 00920-5004
Phone
(787) 783-4285
NPI assigned
Apr 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2929 PR Primary

Addresses

Primary practice location

733 Ave de Diego
San Juan, PR 00920-5004

Mailing address

2117 Calle Lerna
Guaynabo, PR 00969-4936
Phone (787) 512-5373

Other names 1

  • Ana Ivelisse Martinez de Andino Professional name

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

LicenseStateTypeSpecialty
2929PRMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Maxsal Drug, Inc. PastSince Apr 20, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1033799952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2117 CALLE LERNA",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009694936",
            "telephone_number": "787-512-5373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 AVE DE DIEGO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009205004",
            "telephone_number": "787-783-4285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ DE ANDINO",
        "first_name": "ANA IVELISSE",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PR",
            "license": "2929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANA IVELISSE",
            "last_name": "MARTINEZ DE ANDINO",
            "credential": "PHARMACIST",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.