Active NPI
Debora Fuertes-Pacheco
- Pharmacist
- Bradenton, FL
National Provider Identifier
1225428956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PSI29790
- Practice address
- 702 51St St E Apt 1110a
Bradenton, FL 34208-5617 - Phone
- (787) 402-1532
- NPI assigned
- Feb 3, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 | PSI29790 | FL | Primary |
Addresses
Primary practice location
702 51St St E Apt 1110a
Bradenton, FL 34208-5617
Mailing address
702 51St St E Apt 1110a
Bradenton, FL 34208-5617
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSI29790 | Other | FL | DEPARTMENT OF HEALTH |
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 |
|---|---|---|---|
| PSI29790 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627689600000",
"number": "1225428956",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "702 51ST ST E APT 1110A",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342085617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "702 51ST ST E APT 1110A",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342085617",
"telephone_number": "787-402-1532"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUERTES-PACHECO",
"first_name": "DEBORA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-02-03",
"last_updated": "2021-07-31",
"certification_date": "2021-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PSI29790",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF HEALTH",
"identifier": "PSI29790",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bradenton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.