Individual provider Active NPI

Jose Ruben Mercado Vazquez, PHARMD

  • Pharmacist
  • Bayamon, PR
National Provider Identifier
1649708868
Registry record updated Jun 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
6363 Issued in PR
Practice address
2114 Carr PR 2 Int Calle Morales
CVS Pharmacy 4594
Bayamon, PR 00961
Phone
(787) 740-2850
NPI assigned
Jun 1, 2017
Last updated
Jun 1, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 6363 PR Primary

Addresses

Primary practice location

2114 Carr PR 2 Int Calle Morales
CVS Pharmacy 4594
Bayamon, PR 00961

Mailing address

99 Calle Limonero
Bel Air
Guaynabo, PR 00971
Phone (787) 504-1348

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
6363PRMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496275200000",
    "number": "1649708868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 CALLE LIMONERO",
            "address_2": "BEL AIR",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00971",
            "telephone_number": "787-504-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 CARR PR 2 INT CALLE MORALES",
            "address_2": "CVS PHARMACY 4594",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00961",
            "telephone_number": "787-740-2850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO VAZQUEZ",
        "first_name": "JOSE",
        "middle_name": "RUBEN",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-01",
        "last_updated": "2017-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PR",
            "license": "6363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2017; 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.