Active NPI
Mildred Medina, PHARMACIST
- Pharmacist
- Fajardo, PR
National Provider Identifier
1669765400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 4645
- Practice address
- 4203 Calle Marginal
Fajardo, PR 00738-3652 - Phone
- (787) 860-1600
- Fax
- (787) 860-1614
- NPI assigned
- May 26, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 4645 | PR | Primary |
Addresses
Primary practice location
4203 Calle Marginal
Fajardo, PR 00738-3652
Mailing address
4203 Calle Marginal
Fajardo, PR 00738-3652
Phone (787) 860-1600
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4645 | PR | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pharmacy
- Fajardo, PR
- NPI 1972518876
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306368000000",
"number": "1669765400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4203 CALLE MARGINAL",
"city": "FAJARDO",
"state": "PR",
"postal_code": "007383652",
"telephone_number": "787-860-1600",
"fax_number": "787-860-1614"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4203 CALLE MARGINAL",
"city": "FAJARDO",
"state": "PR",
"postal_code": "007383652",
"telephone_number": "787-860-1600",
"fax_number": "787-860-1614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "MILDRED",
"credential": "PHARMACIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-26",
"last_updated": "2011-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PR",
"license": "4645",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fajardo, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.