Active NPI
Idelisse M Perez
- Pharmacist
- San Juan, PR
National Provider Identifier
1336279322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 004908
- Practice address
- 1304 Ave Jesus T Pinero
San Juan, PR 00921-1508 - Phone
- (787) 783-9855
- Fax
- (787) 782-7995
- NPI assigned
- Mar 7, 2007
- Last updated
- Jul 8, 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 | 004908 | PR | Primary |
Addresses
Primary practice location
1304 Ave Jesus T Pinero
San Juan, PR 00921-1508
Mailing address
#A 42 Santa Anastacia Urbanizacion El Vigia
San Juan, PR 00926
Phone (787) 783-9855
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 |
|---|---|---|---|
| 004908 | PR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336279322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "#A 42 SANTA ANASTACIA URBANIZACION EL VIGIA",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00926",
"telephone_number": "787-783-9855",
"fax_number": "787-782-7995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1304 AVE JESUS T PINERO",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009211508",
"telephone_number": "787-783-9855",
"fax_number": "787-782-7995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "IDELISSE",
"middle_name": "M",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PR",
"license": "004908",
"primary": true
}
],
"identifiers": [],
"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 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.