Active NPI
Nicole Medina, PHARMD
- Pharmacist
- San Juan, PR
National Provider Identifier
1093353617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 6731
- Practice address
- 150 Calle F Vizcarrondo
San Juan, PR 00926-4483 - Phone
- (787) 755-1375
- NPI assigned
- Dec 13, 2019
- Last updated
- Dec 13, 2019
- 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 | 6731 | PR | Primary |
Addresses
Primary practice location
150 Calle F Vizcarrondo
San Juan, PR 00926-4483
Mailing address
Palacios Reales 271 Calle Minive
Toa Alta, PR 00953
Phone (787) 679-2731
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 |
|---|---|---|---|
| 6731 | PR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576195200000",
"number": "1093353617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PALACIOS REALES 271 CALLE MINIVE",
"city": "TOA ALTA",
"state": "PR",
"postal_code": "00953",
"telephone_number": "787-679-2731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 CALLE F VIZCARRONDO",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009264483",
"telephone_number": "787-755-1375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "NICOLE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-13",
"last_updated": "2019-12-13",
"certification_date": "2019-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PR",
"license": "6731",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Dec 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.