Individual provider Active NPI

Juan Santos-Olivares, RPH, PHARM D

  • Pharmacist
  • Ponce, PR
National Provider Identifier
1831174630
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
4030 Issued in PR
Practice address
553 Calle Ramos Antonini
El Tuque
Ponce, PR 00728-4806
Phone
(787) 844-2805
Fax
(787) 841-5551
NPI assigned
Dec 14, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 4030 PR Primary

Addresses

Primary practice location

553 Calle Ramos Antonini
El Tuque
Ponce, PR 00728-4806

Mailing address

A18 Calle Palma Real
Villas del Sagrado Corazon
Ponce, PR 00716
Phone (787) 647-0590

Other identifiers 2

IdentifierTypeStateIssuer
0417OtherPRVACCINE PROVIDER
4030OtherPRSTATE LICENSE

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, Registered Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Farmacia El Tuque Current Accepting new patients

Locations

553 Calle Ramos Antonini
Ponce, PR 00728
Phone (787) 675-3602

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": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1831174630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "A18 CALLE PALMA REAL",
            "address_2": "VILLAS DEL SAGRADO CORAZON",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00716",
            "telephone_number": "787-647-0590",
            "fax_number": "787-841-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "553 CALLE RAMOS ANTONINI",
            "address_2": "EL TUQUE",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007284806",
            "telephone_number": "787-844-2805",
            "fax_number": "787-841-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS-OLIVARES",
        "first_name": "JUAN",
        "name_prefix": "Dr.",
        "credential": "RPH, PHARM D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2021-05-17",
        "certification_date": "2021-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PR",
            "license": "4030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VACCINE PROVIDER",
            "identifier": "0417",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "4030",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; 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.