Active NPI
Jessica M Rivera Roman
- Pharmacy Technician
- Carolina, PR
National Provider Identifier
1508123951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 003542
- Practice address
- Corporacion del Fondo del Seguro del Estado
Carr #3 65TH Infanteria
Carolina, PR 00985 - Phone
- (787) 349-9417
- NPI assigned
- Apr 23, 2012
- 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 | 003542 | PR | Primary |
Addresses
Primary practice location
Corporacion del Fondo del Seguro del Estado
Carr #3 65TH Infanteria
Carolina, PR 00985
Mailing address
PO Box
30651
San Juan, PUERTO RICO 00929
UM
Phone (787) 349-9417
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4220980 | Other | PR | DRIVERS LICENCE |
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 |
|---|---|---|---|
| 003542 | PR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335139200000",
"number": "1508123951",
"addresses": [
{
"country_code": "UM",
"country_name": "United States Minor Outlying Islands",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "PO BOX",
"address_2": "30651",
"city": "SAN JUAN",
"state": "PUERTO RICO",
"postal_code": "00929",
"telephone_number": "787-349-9417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CORPORACION DEL FONDO DEL SEGURO DEL ESTADO",
"address_2": "CARR #3 65TH INFANTERIA",
"city": "CAROLINA",
"state": "PR",
"postal_code": "00985",
"telephone_number": "787-349-9417"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA ROMAN",
"first_name": "JESSICA",
"middle_name": "M",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-04-23",
"last_updated": "2012-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "PR",
"license": "003542",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVERS LICENCE",
"identifier": "4220980",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Carolina, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.