Healthcare Provider Details

I. General information

NPI: 1144035338
Provider Name (Legal Business Name): PAMELA GONZALEZ MERCADO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2025
Last Update Date: 02/12/2025
Certification Date: 02/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 CARR 140
BARCELONETA PR
00617-2261
US

IV. Provider business mailing address

HC 4 BOX 49000
HATILLO PR
00659-8506
US

V. Phone/Fax

Practice location:
  • Phone: 787-846-6829
  • Fax:
Mailing address:
  • Phone: 787-406-5137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number8374
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: