Jansen Mendoza Liwanag, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

62183 Issued in FL

Practice address

115 E State Road 434
Longwood, FL 32750-5273

Phone

(407) 830-7350

NPI assigned

Jun 24, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: rxm.03131@store.walgreens.com

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.

• Walgreen Co

  • Pharmacy
  • Longwood, FL
  • NPI 1740295930
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1624492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1316516222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 DOUGLAS AVE",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327142030",
            "telephone_number": "407-617-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E STATE ROAD 434",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327505273",
            "telephone_number": "407-830-7350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1920 Aloma Ave",
            "address_purpose": "LOCATION",
            "city": "Winter Park",
            "state": "FL",
            "postal_code": "327923207",
            "country_code": "US",
            "telephone_number": "407-628-1899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIWANAG",
        "first_name": "JANSEN",
        "middle_name": "MENDOZA",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-24",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "62183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "RXM.03131@store.walgreens.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "115 E State Road 434",
            "city": "Longwood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327505273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "RXM.03131@store.walgreens.com",
            "affiliation": "N",
            "endpointDescription": "E-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1920 Aloma Ave",
            "city": "Winter Park",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327923207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kristyn Line, ARNP
• Little Angels Home Health
• Little Angels Pediatric Extended Care LLC
• Little Angels Pediatric Extended Care LLC
• Live Well Natural Medicine
• Jarod Llewellyn
• Brandon Edward Locklear, M.D.
• Katherine Lombardo
• Anna Lommerse, RMHCI
• Teresa Marina Long, LMT

• Pharmacist in Longwood, FL
• Providers in Longwood, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.

Verify at the official NPI Registry.