Active NPI
Mariely Diaz Vargas, CPH.T
- Pharmacy Technician
- Villalba, PR
National Provider Identifier
1407416803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 4119
- Practice address
- Carr 149 KM 57.4 Bo Tierra Santa
Villalba, PR 00766 - Phone
- (787) 847-9393
- Fax
- (787) 847-9292
- NPI assigned
- Jun 18, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | 4119 | PR | Primary |
Addresses
Primary practice location
Carr 149 KM 57.4 Bo Tierra Santa
Villalba, PR 00766
Mailing address
Urb Jaime L Drew
104 Ave D
Ponce, PR 00730
Phone (787) 847-9393
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4119 | Other | PR | LICENSE |
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 |
|---|---|---|---|
| 4119 | PR | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560816000000",
"number": "1407416803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "URB JAIME L DREW",
"address_2": "104 AVE D",
"city": "PONCE",
"state": "PR",
"postal_code": "00730",
"telephone_number": "787-847-9393",
"fax_number": "787-847-9292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CARR 149 KM 57.4 BO TIERRA SANTA",
"city": "VILLALBA",
"state": "PR",
"postal_code": "00766",
"telephone_number": "787-847-9393",
"fax_number": "787-847-9292"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ VARGAS",
"first_name": "MARIELY",
"name_prefix": "Miss",
"credential": "CPH.T",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-06-18",
"last_updated": "2019-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacy Technician",
"state": "PR",
"license": "4119",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "4119",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Villalba, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.