Individual provider Active NPI

Juan Pablo Valenzuela

  • Pharmacist
  • Nogales, AZ
National Provider Identifier
1679974067
Registry record updated Sep 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S020303 Issued in AZ
Practice address
300 W Mariposa Rd
Nogales, AZ 85621-1043
Phone
(251) 599-8479
NPI assigned
Sep 4, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S020303 AZ Primary

Addresses

Primary practice location

300 W Mariposa Rd
Nogales, AZ 85621-1043

Mailing address

70 W Camino Rancho Lucido
Sahuarita, AZ 85629-8971
Phone (251) 599-8479

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
S020303AZMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1409788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409788800000",
    "number": "1679974067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 W CAMINO RANCHO LUCIDO",
            "city": "SAHUARITA",
            "state": "AZ",
            "postal_code": "856298971",
            "telephone_number": "251-599-8479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W MARIPOSA RD",
            "city": "NOGALES",
            "state": "AZ",
            "postal_code": "856211043",
            "telephone_number": "251-599-8479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENZUELA",
        "first_name": "JUAN",
        "middle_name": "PABLO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-04",
        "last_updated": "2014-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S020303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nogales, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2014; 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.