MEDICARE: DR. MARCOS A FARINACCI MERCADO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	17499	PR

General Provider Information

NPI Number	:	1467692723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARCOS A FARINACCI MERCADO M.D.

Provider Business Mailing Address
First Line	:	CATEDRAL D12,PASEO SAN JUAN
Second Line	:
City	:	RIO PIEDRAS
State	:	PR
Zip	:	00926-0000
Country	:	US
Telephone Number	:	787-424-5352
Fax Number	:

Provider Business Practice Location Address
First Line	:	D12 CATEDRAL, PASEO SAN JUAN
Second Line	:
City	:	RIO PIEDRAS
State	:	PR
Zip	:	00926-0000
Country	:	US
Telephone Number	:	787-424-5352
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2009
Last Update Date	:	06/22/2009

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