Healthcare Provider Details

I. General information

NPI: 1679689624
Provider Name (Legal Business Name): PEDRO FRANCISCO MERCADO PESANTE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

C-19 BLOQ 20-6 VILLA CAROLINA
CAROLINA PR
00985
US

IV. Provider business mailing address

C-19 BLOQ 20-6 VILLA CAROLINA
CAROLINA PR
00985
US

V. Phone/Fax

Practice location:
  • Phone: 787-646-4790
  • Fax: 787-768-7591
Mailing address:
  • Phone: 787-646-4790
  • Fax: 787-768-7591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: