Individual provider Active NPI

Rafael Enrique Graulau

  • Pharmacist
  • Guaynabo, PR
National Provider Identifier
1205578564
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
4988842 Issued in PR
Practice address
35 Calle Juan C Borbon Ste 77
Df02400-0
Guaynabo, PR 00969
Phone
(787) 287-3725
Fax
(787) 287-3711
NPI assigned
Apr 8, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 4988842 PR Primary

Addresses

Primary practice location

35 Calle Juan C Borbon Ste 77
Df02400-0
Guaynabo, PR 00969

Mailing address

469 Ave Esmeralda
Cond Plaza Esmeralda Apt 122
Guaynabo, PR 00969
Phone (787) 307-5920

Other identifiers 2

IdentifierTypeStateIssuer
4093048OtherPR4093048
4093048OtherPRPHARMACY INTERN EMPLOYEE ID

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
4988842PRMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince Apr 10, 2022 Accepting new patients
Walgreen Co PastSince Apr 10, 2022 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": "1649376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649376000000",
    "number": "1205578564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "469 AVE ESMERALDA",
            "address_2": "COND PLAZA ESMERALDA APT 122",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00969",
            "telephone_number": "787-307-5920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 CALLE JUAN C BORBON STE 77",
            "address_2": "DF02400-0",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00969",
            "telephone_number": "787-287-3725",
            "fax_number": "787-287-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAULAU",
        "first_name": "RAFAEL",
        "middle_name": "ENRIQUE",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-08",
        "last_updated": "2022-04-08",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PR",
            "license": "4988842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "4093048",
            "identifier": "4093048",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY INTERN EMPLOYEE ID",
            "identifier": "4093048",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; 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.