Active NPI
Ivelisse Roman
- Pharmacy Technician
- Moca, PR
National Provider Identifier
1710044722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 4961
- Practice address
- 835 Calle Concepcion Vera
Moca, PR 00676-5016 - Phone
- (787) 818-4839
- Fax
- (787) 877-8129
- NPI assigned
- Jan 2, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | 4961 | PR | Primary |
Addresses
Primary practice location
835 Calle Concepcion Vera
Moca, PR 00676-5016
Mailing address
835 Calle Concepcion Vera
Moca, PR 00676-5016
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 |
|---|---|---|---|
| 4961 | PR | MD | Pharmacy Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Farmacia El Divino Nino LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Moca, PR
- NPI 1720185655
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710044722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "835 CALLE CONCEPCION VERA",
"city": "MOCA",
"state": "PR",
"postal_code": "006765016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "835 CALLE CONCEPCION VERA",
"city": "MOCA",
"state": "PR",
"postal_code": "006765016",
"telephone_number": "787-818-4839",
"fax_number": "787-877-8129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROMAN",
"first_name": "IVELISSE",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "PR",
"license": "4961",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moca, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.