Super Farmacia San Jose de Aibonito Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SUPER FARMACIA SAN JOSE DE AIBONITO INC

Doing business as

Super Farmacia San Jose

Practice address

300 Calle San Jose Esq Mercedita Serralles
Aibonito, PR 00705

Phone

(787) 735-3025

Fax

(787) 735-2725

NPI assigned

Nov 21, 2006

Last updated

Jul 21, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rafael Rivera Olivencia, RPH

Title

President

Phone

(787) 735-3025

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• SUPER FARMACIA SAN JOSE Doing business as

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rafael Rivera, RPH

  • Pharmacist
  • Aibonito, PR
  • NPI 1295992469
  NPD

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753056000000",
    "number": "1396810156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2021",
            "city": "AIBONITO",
            "state": "PR",
            "postal_code": "007052021",
            "telephone_number": "787-735-3025",
            "fax_number": "787-735-2725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CALLE SAN JOSE ESQ MERCEDITA SERRALLES",
            "city": "AIBONITO",
            "state": "PR",
            "postal_code": "00705",
            "telephone_number": "787-735-3025",
            "fax_number": "787-735-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPER FARMACIA SAN JOSE DE AIBONITO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-08",
        "status": "A",
        "authorized_official_last_name": "RIVERA OLIVENCIA",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-735-3025",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PR",
            "license": "19-F-3483",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037722100",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2085519",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUPER FARMACIA SAN JOSE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carmen Enid Sierra, RPH
• Juan Ramon Silva, M.D.
• Carmen M Solivan Rivera
• Yaima Soto Padilla, M.D.
• Jeisela Suarez Gil
• Juan F Terreforte-Diaz
• Nannette Geralda Toro, M.D.
• Hector Jose Felix Torres Colon, PA
• Wanda E Torres Hernandez, PHD
• Hermes Torres Martinez Sr.

• Community/Retail Pharmacy in Aibonito, PR
• Providers in Aibonito, PR by specialty
• Community/Retail Pharmacy in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.