Active NPI
Kevin Omar Medina Gomez
- Pharmacist
- Bajadero, PR
National Provider Identifier
1700716495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 8691
- Practice address
- HC 2 Box 7904
Bajadero, PR 00616-9902 - Phone
- (939) 243-4157
- NPI assigned
- May 22, 2026
- Sex
- Male
- 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 | 8691 | PR | Primary |
Addresses
Primary practice location
HC 2 Box 7904
Bajadero, PR 00616-9902
Mailing address
HC 2 Box 7904
Bajadero, PR 00616-9902
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 |
|---|---|---|---|
| 8691 | PR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1779408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779408000000",
"number": "1700716495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HC 2 BOX 7904",
"city": "BAJADERO",
"state": "PR",
"postal_code": "006169902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "HC 2 BOX 7904",
"city": "BAJADERO",
"state": "PR",
"postal_code": "006169902",
"telephone_number": "939-243-4157"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA GOMEZ",
"first_name": "KEVIN",
"middle_name": "OMAR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-05-22",
"last_updated": "2026-05-22",
"certification_date": "2026-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PR",
"license": "8691",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bajadero, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.