Provider Demographics
NPI:1548367972
Name:MERCADO, TRINIDAD (MD)
Entity type:Individual
Prefix:DR
First Name:TRINIDAD
Middle Name:
Last Name:MERCADO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PMB 267
Mailing Address - Street 2:PO BOX 70344
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-0000
Mailing Address - Country:US
Mailing Address - Phone:787-587-3543
Mailing Address - Fax:877-286-4143
Practice Address - Street 1:15 AVE MIGUEL MELENDEZ MUNOZ
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-4604
Practice Address - Country:US
Practice Address - Phone:787-587-3543
Practice Address - Fax:877-286-4143
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14635207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine