Individual provider Active NPI

Roberto Rodriguez, LIC

  • Pharmacist
  • Quebradillas, PR
National Provider Identifier
1386853299
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
07-F-1577 Issued in PR
Practice address
62 Calle Socorro
Quebradillas, PR 00678-1854
Phone
(787) 895-6912
Fax
(787) 895-6912
NPI assigned
May 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 07-F-1577 PR Primary

Addresses

Primary practice location

62 Calle Socorro
Quebradillas, PR 00678-1854

Mailing address

62 Calle Socorro
Quebradillas, PR 00678-1854
Phone (787) 895-6912

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
07-F-1577PRMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386853299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 CALLE SOCORRO",
            "city": "QUEBRADILLAS",
            "state": "PR",
            "postal_code": "006781854",
            "telephone_number": "787-895-6912",
            "fax_number": "787-895-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 CALLE SOCORRO",
            "city": "QUEBRADILLAS",
            "state": "PR",
            "postal_code": "006781854",
            "telephone_number": "787-895-6912",
            "fax_number": "787-895-6912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ROBERTO",
        "name_prefix": "Mr.",
        "credential": "LIC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PR",
            "license": "07-F-1577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quebradillas, 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.

Verify at the official NPI Registry.