=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245278381
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JULIEVA RIOS MERCADO MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/02/2006
-----------------------------------------------------
Last Update Date | 03/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | AVE PONCE DE LEON PDA 37.5
-----------------------------------------------------
City | SAN JUAN
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00919
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-717-6763
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | D-8 LA CATEDRAL PASEO SAN JUAN
-----------------------------------------------------
City | SAN JUAN
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00926-6506
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-717-6763
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207P00000X
-----------------------------------------------------
Taxonomy Name | Emergency Medicine Physician
-----------------------------------------------------
License Number | 9283
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------