Healthcare Provider Details

I. General information

NPI: 1902520968
Provider Name (Legal Business Name): JOSE RAFAEL ALVARADO MERCADO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2022
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB ESTANCIAS DEL LLANO, CALLE LAUREL #48
AIBONITO PR
00705
US

IV. Provider business mailing address

BO HELECHAL CARR 162 R558 K0 H2 INT
BARRANQUITAS PR
00794-0336
US

V. Phone/Fax

Practice location:
  • Phone: 787-320-2620
  • Fax:
Mailing address:
  • Phone: 787-320-2620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number1444-P.A.
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number24875
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number1444
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: