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General NPI Number Information
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NPI Number | 1053078246
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Entity Type | Individual
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Provider Name | CARLOS RAFAEL MERCADO MENDEZ PHARMD
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Gender | Male
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Dates
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Enumeration Date | 11/22/2021
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Last Update Date | 08/19/2022
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Provider Practice Location Address
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Address Line | CARR PR 3 KM 85.9 BO CANDELERO
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City | HUMACAO
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State | PR
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Zip | 00791
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Country | US
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Telephone | 787-850-8011
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Fax | 787-850-5605
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Provider Business Mailing Address
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Address Line | 48 MUNOZ RIVERA COND AQUABLUE APT PH4
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City | SAN JUAN
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State | PR
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Zip | 00918
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Country | US
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Telephone | 787-298-4018
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 6916
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License Number State | PR
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