Active NPI
Jose Luis Cruz Prado, PHARMD
- Pharmacist
- Charlotte, NC
National Provider Identifier
1073819587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 19331
- Practice address
- 4391 Central Ave
Charlotte, NC 28205-5795 - Phone
- (704) 535-5280
- Fax
- (704) 566-8476
- NPI assigned
- Jan 31, 2011
- Sex
- Male
- 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 | 19331 | NC | Primary |
Addresses
Primary practice location
4391 Central Ave
Charlotte, NC 28205-5795
Mailing address
4391 Central Ave
Charlotte, NC 28205-5795
Phone (704) 535-5280
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19331 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377475200000",
"number": "1073819587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4391 CENTRAL AVE",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282055795",
"telephone_number": "704-535-5280",
"fax_number": "704-566-8476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4391 CENTRAL AVE",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282055795",
"telephone_number": "704-535-5280",
"fax_number": "704-566-8476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ PRADO",
"first_name": "JOSE",
"middle_name": "LUIS",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-01-31",
"last_updated": "2013-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "19331",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.