Active NPI
Maria M. Jimenez
- Pharmacist
- San Juan, PR
National Provider Identifier
1942672712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 6308
- Practice address
- 4490 Kmart Pharmacy San Patricio Plaza
Urb Caparra Heigths
San Juan, PR 00920 - Phone
- (787) 792-7708
- Fax
- (184) 739-6290
- NPI assigned
- Oct 20, 2015
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 6308 | PR | Primary |
Addresses
Primary practice location
4490 Kmart Pharmacy San Patricio Plaza
Urb Caparra Heigths
San Juan, PR 00920
Mailing address
4490 Kmart Pharmacy San Patricio Plaza
Urb Caparra Heigths
San Juan, PR 00920
Phone (787) 792-7708
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 |
|---|---|---|---|
| 6308 | PR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445299200000",
"number": "1942672712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4490 KMART PHARMACY SAN PATRICIO PLAZA",
"address_2": "URB CAPARRA HEIGTHS",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00920",
"telephone_number": "787-792-7708",
"fax_number": "184-739-6290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4490 KMART PHARMACY SAN PATRICIO PLAZA",
"address_2": "URB CAPARRA HEIGTHS",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00920",
"telephone_number": "787-792-7708",
"fax_number": "184-739-6290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIMENEZ",
"first_name": "MARIA",
"middle_name": "M.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-20",
"last_updated": "2015-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PR",
"license": "6308",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.