MEDICARE: ALEJANDRO 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	2080P0214X	Pediatric Pulmonology Physician	6371	PR

General Provider Information

NPI Number	:	1568482743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEJANDRO MERCADO M.D.

Provider Business Mailing Address
First Line	:	BALDWIN PARK
Second Line	:	33 EAST SIDE COURT
City	:	GUAYNABO
State	:	PR
Zip	:	00969
Country	:	US
Telephone Number	:	787-780-6034
Fax Number	:	787-999-5823

Provider Business Practice Location Address
First Line	:	1845 CARR. #2
Second Line	:	BAYAMON MEDICAL PLAZA STE. #305
City	:	BAYAMON
State	:	PR
Zip	:	00959-7203
Country	:	US
Telephone Number	:	787-780-6034
Fax Number	:	787-999-5823

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

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	07/08/2007

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