Active NPI
Jomar Alexis Medina Ortiz
- Pharmacist
- Dorado, PR
National Provider Identifier
1407535438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 08256
- Practice address
- 4210 PR-693
Dorado, PR 00646 - Phone
- (787) 278-5811
- NPI assigned
- Jul 17, 2023
- Last updated
- May 24, 2024
- 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 | 08256 | PR | Primary |
Addresses
Primary practice location
4210 PR-693
Dorado, PR 00646
Mailing address
Calle San Agustin B39
Urb. Los Dominicos
Bayamon, PR 00957
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 |
|---|---|---|---|
| 08256 | PR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716508800000",
"number": "1407535438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "CALLE SAN AGUSTIN B39",
"address_2": "URB. LOS DOMINICOS",
"city": "BAYAMON",
"state": "PR",
"postal_code": "00957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4210 PR-693",
"city": "DORADO",
"state": "PR",
"postal_code": "00646",
"telephone_number": "787-278-5811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA ORTIZ",
"first_name": "JOMAR",
"middle_name": "ALEXIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-07-17",
"last_updated": "2024-05-24",
"certification_date": "2024-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PR",
"license": "08256",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dorado, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.