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General NPI Number Information
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NPI Number | 1699852632
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Entity Type | Individual
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Provider Name | MERARDO ANTONIO BECERRA MEDICAL DOCTOR
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1700 CALLE FEDERICO MONTILLA S APT. 1402 SUR
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City | BAYAMON
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State | PR
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Zip | 00956-3065
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Country | US
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Telephone | 787-787-7838
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Fax |
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Provider Business Mailing Address
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Address Line | COND TORRES DEL PARQUE, APT. 1402 SUR
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City | BAYAMON
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State | PR
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Zip | 00956-3070
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Country | US
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Telephone | 787-787-7838
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 16,300
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License Number State | PR
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