Individual provider Active NPI

Elsie Angelic Diaz Baez

  • Pharmacist
  • San Juan, PR
National Provider Identifier
1114486636
Registry record updated Mar 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
6606 Issued in PR
Practice address
1185 Ave 65 Infanteria
San Juan, PR 00924-3403
Phone
(787) 999-7203
NPI assigned
Mar 14, 2019
Last updated
Mar 14, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 6606 PR Primary

Addresses

Primary practice location

1185 Ave 65 Infanteria
San Juan, PR 00924-3403

Mailing address

CC9 Calle Yunquesito
Urb Mansiones de Carolina
Carolina, PR 00987
Phone (787) 517-2363

Other identifiers 1

IdentifierTypeStateIssuer
6303OtherPRIMMUNIZATION LICENCE

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
6606PRMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1552521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552521600000",
    "number": "1114486636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CC9 CALLE YUNQUESITO",
            "address_2": "URB MANSIONES DE CAROLINA",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00987",
            "telephone_number": "787-517-2363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1185 AVE 65 INFANTERIA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009243403",
            "telephone_number": "787-999-7203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ BAEZ",
        "first_name": "ELSIE",
        "middle_name": "ANGELIC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-14",
        "last_updated": "2019-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PR",
            "license": "6606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IMMUNIZATION LICENCE",
            "identifier": "6303",
            "state": "PR"
        }
    ],
    "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 Mar 14, 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.