Individual provider Active NPI

Wanda I Gonzalez, RPH

  • Pharmacist
  • Aguada, PR
National Provider Identifier
1609902014
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
4896 Issued in PR
Practice address
52 Calle Amapola
Urb. Las Flores
Aguada, PR 00602-2428
Phone
(787) 868-7754
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 4896 PR Primary

Addresses

Primary practice location

52 Calle Amapola
Urb. Las Flores
Aguada, PR 00602-2428

Mailing address

52 Calle Amapola
Urb. Las Flores
Aguada, PR 00602-2428
Phone (787) 868-7754

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
4896PRMDPharmacy Technician

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609902014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 CALLE AMAPOLA",
            "address_2": "URB. LAS FLORES",
            "city": "AGUADA",
            "state": "PR",
            "postal_code": "006022428",
            "telephone_number": "787-868-7754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 CALLE AMAPOLA",
            "address_2": "URB. LAS FLORES",
            "city": "AGUADA",
            "state": "PR",
            "postal_code": "006022428",
            "telephone_number": "787-868-7754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "WANDA",
        "middle_name": "I",
        "name_prefix": "Miss",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PR",
            "license": "4896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aguada, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.