Individual provider Active NPI

Rodrigo Nino Nunez

  • Medical Technologist
  • San Juan, PR
National Provider Identifier
1255715975
Registry record updated Jul 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical TechnologistTaxonomy code 246QM0706X
License
8369 Issued in PR
Practice address
150 Bo Monacillo Americo Miranda Ave
Area de Centro Medico Metropolitano
San Juan, PR 00935-0001
Phone
(787) 421-5594
NPI assigned
Jul 13, 2015
Last updated
Jul 13, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Technologist 246QM0706X 8369 PR Primary

Addresses

Primary practice location

150 Bo Monacillo Americo Miranda Ave
Area de Centro Medico Metropolitano
San Juan, PR 00935-0001

Mailing address

14 Calle Baldorioty Apt 202
Caguas, PR 00725-3506
Phone (787) 421-5594

Other identifiers 1

IdentifierTypeStateIssuer
0080026208104MedicaidPR

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
8369PRMDMedical Technologist

NPI Registry JSON

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436745600000",
    "number": "1255715975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 CALLE BALDORIOTY APT 202",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007253506",
            "telephone_number": "787-421-5594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 BO MONACILLO AMERICO MIRANDA AVE",
            "address_2": "AREA DE CENTRO MEDICO METROPOLITANO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009350001",
            "telephone_number": "787-421-5594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NINO NUNEZ",
        "first_name": "RODRIGO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-13",
        "last_updated": "2015-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246QM0706X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Medical Technologist",
            "state": "PR",
            "license": "8369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0080026208104",
            "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 Jul 13, 2015; 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.