MEDICARE: DR. NICOLE DE LA TORRE MERCADO PSY.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	6991	PR

General Provider Information

NPI Number	:	1528639895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICOLE DE LA TORRE MERCADO PSY.D

Provider Business Mailing Address
First Line	:	PO BOX 262
Second Line	:
City	:	CABO ROJO
State	:	PR
Zip	:	00623-0262
Country	:	US
Telephone Number	:	787-458-9359
Fax Number	:

Provider Business Practice Location Address
First Line	:	369 AV ESCORIAL
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00920
Country	:	UM
Telephone Number	:	787-377-2035
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2021
Last Update Date	:	05/15/2026

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