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General NPI Number Information
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NPI Number | 1700022282
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Entity Type | Individual
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Provider Name | KATHERINE I MERCADO-NAZARIO M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/05/2009
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Last Update Date | 03/16/2023
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Provider Practice Location Address
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Address Line | KM 31.7 CARR #2 BARRIO BAJURA
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City | VEGA ALTA
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State | PR
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Zip | 00692
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Country | US
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Telephone | 787-941-3619
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Fax | 903-213-9127
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Provider Business Mailing Address
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Address Line | PO BOX 3187
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City | BAYAMON
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State | PR
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Zip | 00960-3187
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Country | US
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Telephone | 787-529-0437
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 17401
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License Number State | PR
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