MEDICARE: MYRIAM PEREZ-MERCADO

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	103T00000X	Psychologist	8833	PR

General Provider Information

NPI Number	:	1477417608
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MYRIAM PEREZ-MERCADO

Provider Business Mailing Address
First Line	:	920 CARR 175 APT 7202
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926-9262
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	920 CARR 175 APT 7202
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926-9262
Country	:	US
Telephone Number	:	787-368-1261
Fax Number	:

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

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	12/11/2025

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Directions to “ MYRIAM PEREZ-MERCADO ” Practice Location

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