Active NPI
Martin Perdomo
- Pharmacist
- San Juan, PR
National Provider Identifier
1356893150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 4262
- Practice address
- PR-2 KM 2.2 Kennedy Ave
Marginal John F Kennedy
San Juan, PR 00936-0000 - Phone
- (787) 522-3601
- Fax
- (787) 522-3609
- NPI assigned
- Oct 27, 2016
- Sex
- Male
- 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 | 4262 | PR | Primary |
Addresses
Primary practice location
PR-2 KM 2.2 Kennedy Ave
Marginal John F Kennedy
San Juan, PR 00936-0000
Mailing address
PR2 KM 2.2 Kennedy Ave
Marginal John F Kennedy
San Juan, PR 00936-0000
Phone (787) 522-3601
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 |
|---|---|---|---|
| 4262 | PR | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477526400000",
"number": "1356893150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PR2 KM 2.2 KENNEDY AVE",
"address_2": "MARGINAL JOHN F KENNEDY",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009360000",
"telephone_number": "787-522-3601",
"fax_number": "787-522-3609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PR-2 KM 2.2 KENNEDY AVE",
"address_2": "MARGINAL JOHN F KENNEDY",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009360000",
"telephone_number": "787-522-3601",
"fax_number": "787-522-3609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERDOMO",
"first_name": "MARTIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-10-27",
"last_updated": "2016-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PR",
"license": "4262",
"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 Oct 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.