Healthcare Provider Details

I. General information

NPI: 1568482743
Provider Name (Legal Business Name): ALEJANDRO MERCADO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1845 CARR. #2 BAYAMON MEDICAL PLAZA STE. #305
BAYAMON PR
00959-7203
US

IV. Provider business mailing address

BALDWIN PARK 33 EAST SIDE COURT
GUAYNABO PR
00969
US

V. Phone/Fax

Practice location:
  • Phone: 787-780-6034
  • Fax: 787-999-5823
Mailing address:
  • Phone: 787-780-6034
  • Fax: 787-999-5823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number6371
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: