Healthcare Provider Details

I. General information

NPI: 1184617615
Provider Name (Legal Business Name): LAS AMERICAS MEDICAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

J15 CALLE 2 URB HERMANAS DAVILA
BAYAMON PR
00959-5001
US

IV. Provider business mailing address

PO BOX 127
BAYAMON PR
00960-0127
US

V. Phone/Fax

Practice location:
  • Phone: 787-780-0534
  • Fax: 787-780-0534
Mailing address:
  • Phone: 787-780-0534
  • Fax: 787-780-0534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number5839
License Number StatePR

VIII. Authorized Official

Name: DR. SALVADOR MERCADO MERCADO SR.
Title or Position: PRESIDENT
Credential: M.D.
Phone: 787-780-0534