Individual provider Active NPI

Wilma Agosto Rosa, RPH

  • Pharmacist
  • San Juan, PR
National Provider Identifier
1992845903
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2287 Issued in PR
Practice address
86 Gergti Rio Piedras
San Juan
San Juan, PR 00928-0122
Phone
(787) 757-6762
Fax
(787) 772-9221
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2287 PR Primary

Addresses

Primary practice location

86 Gergti Rio Piedras
San Juan
San Juan, PR 00928-0122

Mailing address

PO Box 20122
San Juan
San Juan, PR 00928-0122
Phone (787) 757-6762

Other identifiers 1

IdentifierTypeStateIssuer
2287OtherPRLIC DE PR

Other names 1

  • Wilma Agosto Rosa Former name

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

LicenseStateTypeSpecialty
2287PRMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992845903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20122",
            "address_2": "SAN JUAN",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009280122",
            "telephone_number": "787-757-6762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 GERGTI RIO PIEDRAS",
            "address_2": "SAN JUAN",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009280122",
            "telephone_number": "787-757-6762",
            "fax_number": "787-772-9221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSA",
        "first_name": "WILMA",
        "middle_name": "AGOSTO",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PR",
            "license": "2287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC DE PR",
            "identifier": "2287",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WILMA",
            "last_name": "ROSA",
            "middle_name": "AGOSTO",
            "credential": "RPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 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.

Verify at the official NPI Registry.