Individual provider Active NPI

Samantha Gonzales

  • Pharmacotherapy Pharmacist
  • Tucson, AZ
National Provider Identifier
1104341650
Registry record updated Dec 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
61082 Issued in TX
Practice address
3601 S 6TH Ave # 1-119
Tucson, AZ 85723
Phone
(520) 792-1450
NPI assigned
Aug 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X 61082 TX Primary

Addresses

Primary practice location

3601 S 6TH Ave # 1-119
Tucson, AZ 85723

Mailing address

3601 S 6TH Ave # 1-119
Tucson, AZ 85723-0001
Phone (520) 792-1450

Other practice location 1

1601 SW Archer Rd
Gainesville, FL 32608-1135
Phone (352) 376-1611

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
61082TXMDPharmacotherapy Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1501977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575590400000",
    "number": "1104341650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 S 6TH AVE # 1-119",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857230001",
            "telephone_number": "520-792-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 S 6TH AVE # 1-119",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85723",
            "telephone_number": "520-792-1450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326081135",
            "country_code": "US",
            "telephone_number": "352-376-1611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-06",
        "last_updated": "2019-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "TX",
            "license": "61082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.

Verify at the official NPI Registry.