Organization Name: | MANUEL A MERCADO CSP |
NPI Number: | 1184799942 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MANUEL A MERCADO (CHAIRMAN) |
Mailing Address: | 32 Dediego Ave Arecibo |
State: | PR US |
Postal Code: | 00613 |
Phone Number: | 7878786680 |
Fax Number: | 7878786680 |
NPI Enumeration Date: | 11/21/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 5255 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |