Active NPI
Madeline Mangual, LIC 002465
- Pharmacist
- Canovanas, PR
National Provider Identifier
1174645899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 002465
- Practice address
- Calle Autonomia #71
Farmacia San Antonio
Canovanas, PR 00729 - Phone
- (787) 876-2705
- Fax
- (787) 876-0558
- NPI assigned
- Apr 4, 2007
- 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 | 002465 | PR | Primary |
Addresses
Primary practice location
Calle Autonomia #71
Farmacia San Antonio
Canovanas, PR 00729
Mailing address
Calle Orquidea #300
Civdad Aperdin
Carolina, PR 00987
Phone (787) 276-6162
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
| License | State | Type | Specialty |
|---|---|---|---|
| 002465 | PR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174645899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "CALLE ORQUIDEA #300",
"address_2": "CIVDAD APERDIN",
"city": "CAROLINA",
"state": "PR",
"postal_code": "00987",
"telephone_number": "787-276-6162",
"fax_number": "787-876-0558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CALLE AUTONOMIA #71",
"address_2": "FARMACIA SAN ANTONIO",
"city": "CANOVANAS",
"state": "PR",
"postal_code": "00729",
"telephone_number": "787-876-2705",
"fax_number": "787-876-0558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGUAL",
"first_name": "MADELINE",
"name_prefix": "Mrs.",
"credential": "LIC 002465",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PR",
"license": "002465",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canovanas, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.