Provider Demographics
NPI:1538618079
Name:MERCADO, ROSEMIRIAM
Entity type:Individual
Prefix:MISS
First Name:ROSEMIRIAM
Middle Name:
Last Name:MERCADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:Q2 CALLE ROBUSTA
Mailing Address - Street 2:URB. VILLAS DE CAFETAL 2
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-3171
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:Q2 CALLE ROBUSTA
Practice Address - Street 2:URB. VILLAS DE CAFETAL 2
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-3171
Practice Address - Country:US
Practice Address - Phone:787-899-6754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR56648163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse