Individual provider Active NPI

Vladimir Mojica Diaz

  • Optician
  • San Juan, PR
National Provider Identifier
1558104802
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
1359 Issued in PR
Practice address
21 Calle Santa Rosa Apt 508
San Juan, PR 00926-5648
Phone
(787) 321-8882
NPI assigned
Jun 14, 2024
Last updated
Jun 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 1359 PR Primary

Addresses

Primary practice location

21 Calle Santa Rosa Apt 508
San Juan, PR 00926-5648

Mailing address

21 Calle Santa Rosa Apt 508
San Juan, PR 00926-5648
Phone (787) 321-8882

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

LicenseStateTypeSpecialty
1359PRMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1718323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1558104802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 CALLE SANTA ROSA APT 508",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009265648",
            "telephone_number": "787-321-8882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 CALLE SANTA ROSA APT 508",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009265648",
            "telephone_number": "787-321-8882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOJICA DIAZ",
        "first_name": "VLADIMIR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-14",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "PR",
            "license": "1359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.

Verify at the official NPI Registry.