Individual provider Active NPI

Juan Maysonet-Camacho

  • Pharmacist
  • Dorado, PR
National Provider Identifier
1629365838
Registry record updated Jul 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
003077 Issued in PR
Practice address
673 Mar Indico Street
Paseo Los Corales 1
Dorado, PR 00646-4802
Phone
(787) 278-5811
NPI assigned
Jul 8, 2011
Last updated
Jul 8, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 003077 PR Primary

Addresses

Primary practice location

673 Mar Indico Street
Paseo Los Corales 1
Dorado, PR 00646-4802

Mailing address

673 Mar Indico Street
Paseo Los Corales 1
Dorado, PR 00646-4802
Phone (787) 278-0037

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
003077PRMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310083200000",
    "number": "1629365838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "673 MAR INDICO STREET",
            "address_2": "PASEO LOS CORALES 1",
            "city": "DORADO",
            "state": "PR",
            "postal_code": "006464802",
            "telephone_number": "787-278-0037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "673 MAR INDICO STREET",
            "address_2": "PASEO LOS CORALES 1",
            "city": "DORADO",
            "state": "PR",
            "postal_code": "006464802",
            "telephone_number": "787-278-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYSONET-CAMACHO",
        "first_name": "JUAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-08",
        "last_updated": "2011-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PR",
            "license": "003077",
            "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 Jul 8, 2011; 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.