Active NPI
Luis Gonzalez, RPH
- Pharmacist
- Carolina, PR
National Provider Identifier
1740761055
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 4105
- Practice address
- Walmart Puerto Rico Inc
State Road #3 KM 15.2 Barrio Canovanillas
Carolina, PR 00987 - Phone
- (787) 653-7777
- NPI assigned
- Aug 24, 2018
- Last updated
- Aug 24, 2018
- 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 | 4105 | PR | Primary |
Addresses
Primary practice location
Walmart Puerto Rico Inc
State Road #3 KM 15.2 Barrio Canovanillas
Carolina, PR 00987
Mailing address
Walmart Puerto Rico Inc
16300 Monte Real Plaza
Carolina, PR 00987
Phone (787) 653-7777
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4105 | Other | PR | RPH LICENSE NUMBER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4105 | PR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535068800000",
"number": "1740761055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "WALMART PUERTO RICO INC",
"address_2": "16300 MONTE REAL PLAZA",
"city": "CAROLINA",
"state": "PR",
"postal_code": "00987",
"telephone_number": "787-653-7777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "WALMART PUERTO RICO INC",
"address_2": "STATE ROAD #3 KM 15.2 BARRIO CANOVANILLAS",
"city": "CAROLINA",
"state": "PR",
"postal_code": "00987",
"telephone_number": "787-653-7777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "LUIS",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-08-24",
"last_updated": "2018-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PR",
"license": "4105",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RPH LICENSE NUMBER",
"identifier": "4105",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Carolina, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.