Healthcare Provider Details

I. General information

NPI: 1831006634
Provider Name (Legal Business Name): IRISBETH FLORES MERCUCCI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

E2 CALLE ORQUIDEA
YAUCO PR
00698-3468
US

IV. Provider business mailing address

E2 CALLE ORQUIDEA
YAUCO PR
00698-3468
US

V. Phone/Fax

Practice location:
  • Phone: 866-541-6682
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number3726
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: