Individual provider Active NPI

Diana M Torres Fajardo, PHARMD

  • Pharmacist
  • Carolina, PR
National Provider Identifier
1508467531
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
61819 Issued in FL
Practice address
9546 Calle Diaz Way Apt 421
Carolina, PR 00979
Phone
(787) 525-5737
NPI assigned
Nov 5, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 6812 PR
Pharmacist 183500000X 61819 FL Primary

Addresses

Primary practice location

9546 Calle Diaz Way Apt 421
Carolina, PR 00979

Mailing address

9546 Calle Diaz Way Apt 421
Carolina, PR 00979
Phone (787) 525-5737

Other identifiers 2

IdentifierTypeStateIssuer
61819OtherFLFLORIDA DEPARTMENT OF HEALTH - BOARD OF PHARMACY
6812OtherPRPUERTO RICO PHARMACIST 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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
61819FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1604534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1508467531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9546 CALLE DIAZ WAY APT 421",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00979",
            "telephone_number": "787-525-5737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9546 CALLE DIAZ WAY APT 421",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00979",
            "telephone_number": "787-525-5737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORRES FAJARDO",
        "first_name": "DIANA",
        "middle_name": "M",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-05",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PR",
            "license": "6812",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "61819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA DEPARTMENT OF HEALTH - BOARD OF PHARMACY",
            "identifier": "61819",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PUERTO RICO PHARMACIST LICENSE",
            "identifier": "6812",
            "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 Jun 16, 2021; 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.