Individual provider Active NPI

Dianette Badillo-Hernandez, PHARM.D.

  • Pharmacist
  • San Juan, PR
National Provider Identifier
1689746117
Registry record updated Dec 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5200 Issued in PR
Practice address
383 FD Roosevelt Ave
2ND Floor Pharmacy Department
San Juan, PR 00918-2131
Phone
(787) 282-7900
Fax
(888) 788-2991
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5200 PR Primary

Addresses

Primary practice location

383 FD Roosevelt Ave
2ND Floor Pharmacy Department
San Juan, PR 00918-2131

Mailing address

383 FD Roosevelt Ave
2ND Floor Pharmacy Department
San Juan, PR 00918-2131
Phone (787) 282-7900

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
5200PRMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356480000000",
    "number": "1689746117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "383 FD ROOSEVELT AVE",
            "address_2": "2ND FLOOR PHARMACY DEPARTMENT",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009182131",
            "telephone_number": "787-282-7900",
            "fax_number": "888-788-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "383 FD ROOSEVELT AVE",
            "address_2": "2ND FLOOR PHARMACY DEPARTMENT",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009182131",
            "telephone_number": "787-282-7900",
            "fax_number": "888-788-2991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADILLO-HERNANDEZ",
        "first_name": "DIANETTE",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2012-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PR",
            "license": "5200",
            "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 26, 2012; 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.