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General NPI Number Information
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NPI Number | 1538653175
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Entity Type | Individual
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Provider Name | MELISSA COLLADO MERCADO AUD
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Gender | Female
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Dates
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Enumeration Date | 06/18/2018
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Last Update Date | 06/22/2023
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Provider Practice Location Address
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Address Line | PLAZA MONSERRATE SHOPPING CENTER B-1 CARR #2 KM 164.5 INT
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City | HORMIGUEROS
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State | PR
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Zip | 00660
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Country | US
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Telephone | 787-560-4602
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 437
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City | CABO ROJO
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State | PR
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Zip | 00623-0437
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Country | US
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Telephone | 787-393-2816
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 1007
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License Number State | PR
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