Healthcare Provider Details

I. General information

NPI: 1437024726
Provider Name (Legal Business Name): MIRNALY LOPEZ-MERCADO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2025
Last Update Date: 10/07/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE MORSE ESQUINA VALENTINA # 46
ARROYO PR
00714-2633
US

IV. Provider business mailing address

URB. ESTANCIAS EL VIGIA CALLE FARO F-76
GUAYAMA PR
00784
US

V. Phone/Fax

Practice location:
  • Phone: 787-839-4150
  • Fax: 787-839-3989
Mailing address:
  • Phone: 787-839-4150
  • Fax: 787-839-3989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number6320
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: