Active NPI
Ivelisse Medina Ortiz, TECHNICIAN
- Pharmacy Technician
- Yabucoa, PR
National Provider Identifier
1891892105
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 3276
- Practice address
- 5 Calle Cristobal Colon
Yabucoa, PR 00767-3328 - Phone
- (787) 893-2280
- Fax
- (787) 893-6738
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | 3276 | PR | Primary |
Addresses
Primary practice location
5 Calle Cristobal Colon
Yabucoa, PR 00767-3328
Mailing address
HC 2 Box 8874
Yabucoa, PR 00767-8874
Phone (787) 893-1332
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3276 | Other | PR | TECHNICIAN LINCENSE |
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 |
|---|---|---|---|
| 3276 | PR | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891892105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HC 2 BOX 8874",
"city": "YABUCOA",
"state": "PR",
"postal_code": "007678874",
"telephone_number": "787-893-1332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 CALLE CRISTOBAL COLON",
"city": "YABUCOA",
"state": "PR",
"postal_code": "007673328",
"telephone_number": "787-893-2280",
"fax_number": "787-893-6738"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA ORTIZ",
"first_name": "IVELISSE",
"name_prefix": "Mrs.",
"credential": "TECHNICIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "PR",
"license": "3276",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TECHNICIAN LINCENSE",
"identifier": "3276",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yabucoa, 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.