Individual provider Active NPI

Iadelisse Cruz-Gonzalez, PHARMD, BCGP

  • Pharmacist
  • San Juan, PR
National Provider Identifier
1679542344
Registry record updated Dec 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
4433 Issued in PR
Practice address
Upr - School of Pharmacy , Dept. of Pharmacy Practice
Medical Sciences Campus
San Juan, PR 00936-5067
Phone
(787) 758-2525
Fax
(787) 754-6995
NPI assigned
Mar 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS31219 FL
Pharmacist 183500000X 4433 PR Primary

Addresses

Primary practice location

Upr - School of Pharmacy , Dept. of Pharmacy Practice
Medical Sciences Campus
San Juan, PR 00936-5067

Mailing address

PO Box 223
Las Piedras, PR 00771-0223
Phone (787) 716-0052

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
PS31219FLMDPharmacist
4433PRMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1679542344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 223",
            "city": "LAS PIEDRAS",
            "state": "PR",
            "postal_code": "007710223",
            "telephone_number": "787-716-0052",
            "fax_number": "787-716-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UPR - SCHOOL OF PHARMACY , DEPT. OF PHARMACY PRACTICE",
            "address_2": "MEDICAL SCIENCES CAMPUS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009365067",
            "telephone_number": "787-758-2525",
            "fax_number": "787-754-6995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ-GONZALEZ",
        "first_name": "IADELISSE",
        "name_prefix": "Dr.",
        "credential": "PHARMD,  BCGP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS31219",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PR",
            "license": "4433",
            "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 Dec 16, 2021; 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.