Individual provider Active NPI

Mario J. Cruz

  • Pharmacist
  • Aguadilla, PR
National Provider Identifier
1174607451
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
3326 Issued in PR
Practice address
1 Ave San Carlos
Aguadilla, PR 00603-5047
Phone
(787) 891-1060
Fax
(787) 882-7237
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 3326 PR Primary

Addresses

Primary practice location

1 Ave San Carlos
Aguadilla, PR 00603-5047

Mailing address

PO Box 907
Aguadilla, PR 00605-0907
Phone (787) 891-1060

Other practice location 1

110 km 29.3 BO MONTANA
San Antonio
Aguadilla, PR 00605-0907
Phone (787) 890-3535

Other identifiers 2

IdentifierTypeStateIssuer
038322600MedicaidPR
3326OtherPRSTATE LICENSE

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mario de Jesus Cruz Inc PastSince Jun 29, 2025 Accepting new patients
Mario de Jesus Cruz Inc Dba Farmacia la Milagrosa PastSince Jun 29, 2025 Accepting new patients

Organizations & group practices 2

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1174607451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 907",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "006050907",
            "telephone_number": "787-891-1060",
            "fax_number": "787-882-5075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 AVE SAN CARLOS",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "006035047",
            "telephone_number": "787-891-1060",
            "fax_number": "787-882-7237"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 km 29.3 BO MONTANA",
            "address_2": "San Antonio",
            "address_purpose": "LOCATION",
            "city": "Aguadilla",
            "state": "PR",
            "postal_code": "006050907",
            "country_code": "US",
            "telephone_number": "787-890-3535",
            "fax_number": "787-890-1647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "MARIO",
        "middle_name": "J.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PR",
            "license": "3326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038322600",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "3326",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aguadilla, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; 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.