Healthcare Provider Details

I. General information

NPI: 1780850347
Provider Name (Legal Business Name): SYLVIA DE MERCADO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SYLVIA DE L DE MERCADO M.D.

II. Dates (important events)

Enumeration Date: 05/05/2008
Last Update Date: 05/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1851 AVE FERNANDEZ JUNCOS SUITE 101
SANTURCE PR
00909-3011
US

IV. Provider business mailing address

PMB 485 PO BOX 7891
GUAYNABO PR
00970-7891
US

V. Phone/Fax

Practice location:
  • Phone: 787-792-6792
  • Fax:
Mailing address:
  • Phone: 787-579-1208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number5391
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: