Individual provider Active NPI

Juan C Vazquez, RPH

  • Community/Retail Pharmacy
  • Coconut Creek, FL
National Provider Identifier
1730784349
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PS0033961 Issued in FL
Practice address
4650 W Hillsboro Blvd
Coconut Creek, FL 33073-2007
Phone
(954) 426-5224
Fax
(954) 426-5591
NPI assigned
Dec 1, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PS0033961 FL Primary

Addresses

Primary practice location

4650 W Hillsboro Blvd
Coconut Creek, FL 33073-2007

Mailing address

4650 W Hillsboro Blvd
Coconut Creek, FL 33073-2007
Phone (954) 426-5224

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PS0033961FLMDCommunity/Retail Pharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
Holiday CVS L.L.C. Community/Retail Pharmacy PastSince Dec 6, 2020 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.

NPI Registry JSON

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1730784349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 W HILLSBORO BLVD",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330732007",
            "telephone_number": "954-426-5224",
            "fax_number": "954-426-5591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W HILLSBORO BLVD",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330732007",
            "telephone_number": "954-426-5224",
            "fax_number": "954-426-5591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "JUAN",
        "middle_name": "C",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PS0033961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coconut Creek, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; 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.