Healthcare Provider Details

I. General information

NPI: 1922168632
Provider Name (Legal Business Name): MARIA MERCEDES SANCHEZ-LONGO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 03/18/2020
Certification Date: 03/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HOSPITAL AUXILIO MUTUO
SAN JUAN PR
00919
US

IV. Provider business mailing address

634 SAN JORGE 5E
SAN JUAN PR
00912
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-2000
  • Fax:
Mailing address:
  • Phone: 787-634-8138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number8395
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: