Individual provider Active NPI

Pedro Gonzalez Villafan

  • Pharmacist
  • North Las Vegas, NV
National Provider Identifier
1689536476
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
24893 Issued in NV
Practice address
4034 Annendale Ave
North Las Vegas, NV 89031-3617
Phone
(702) 528-1401
NPI assigned
Dec 1, 2025
Last updated
Dec 1, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 24893 NV Primary

Addresses

Primary practice location

4034 Annendale Ave
North Las Vegas, NV 89031-3617

Mailing address

4034 Annendale Ave
North Las Vegas, NV 89031-3617
Phone (702) 528-1401

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
24893NVMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1764547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1689536476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4034 ANNENDALE AVE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890313617",
            "telephone_number": "702-528-1401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4034 ANNENDALE AVE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890313617",
            "telephone_number": "702-528-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ VILLAFAN",
        "first_name": "PEDRO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-12-01",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "24893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2025; 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.