Pueblo Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PUEBLO INC

Practice address

1511 Ave Ponce de Leon
San Juan, PR 00909

Phone

(787) 725-8112

Fax

(787) 725-8115

NPI assigned

Apr 1, 2014

Organization subpart

Yes

Parent organization

PUEBLO INCAs reported in NPPES

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

Authorized official

Name

Luis M Maldonado-Pena

Title

VP Finances

Phone

(787) 757-3131

Specialties & licenses 7

Addresses

Other identifiers 1

Other names 2

• Pueblo Pharmacy 984 Doing business as
• Pueblo Pharmacy #984 Other name

Tax ID family

Pueblo Inc3 organizations share this tax ID, including this one

Part of

Pueblo Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Pueblo Inc

  • Community/Retail Pharmacy
  • San Juan, PR
  • NPI 1184146219
  NPD tax ID
• Pueblo Inc

  • Community/Retail Pharmacy
  • Guaynabo, PR
  • NPI 1831666437
  NPD tax ID

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

{
    "created_epoch": "1396310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755561600000",
    "number": "1992123574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1967",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009841967",
            "telephone_number": "787-757-3131",
            "fax_number": "787-793-8144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 AVE PONCE DE LEON",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00909",
            "telephone_number": "787-725-8112",
            "fax_number": "787-725-8115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUEBLO INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PUEBLO INC",
        "enumeration_date": "2014-04-01",
        "last_updated": "2025-08-19",
        "status": "A",
        "authorized_official_last_name": "MALDONADO-PENA",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "VP FINANCES",
        "authorized_official_telephone_number": "787-757-3131"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "PR",
            "license": "16F3186",
            "primary": false
        },
        {
            "code": "1835G0303X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist, Geriatric",
            "state": "PR",
            "license": "16F3186",
            "primary": false
        },
        {
            "code": "1835N1003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist, Nutrition Support",
            "state": "PR",
            "license": "16F3186",
            "primary": false
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "PR",
            "license": "16F3186",
            "primary": false
        },
        {
            "code": "1835P1300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist, Psychiatric",
            "state": "PR",
            "license": "16F3186",
            "primary": false
        },
        {
            "code": "183700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacy Technician",
            "state": "PR",
            "license": "16F3186",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038204500",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pueblo Pharmacy 984",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pueblo Pharmacy #984",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Pueblo Pharmacy #984",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Psychiatry Wellness Group
• Psychmed Services LLC
• Manuel Pubillones, MD
• Guillermo Antonio Puebla Robles, MD
• Pueblo Inc
• Nicole J Puente Carrasco
• Pablo Odeley Puente Fumero, MD
• Juan Carlos Puentes, MD
• Puerto Rico Advance Medical Devices Corp
• Puerto Rico Assitive Technology Program

• Community/Retail Pharmacy in San Juan, PR
• Providers in San Juan, PR by specialty
• Community/Retail Pharmacy in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; 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.