Provider Demographics
NPI:1548889157
Name:MAYORCA, ALFREDO RAMON (MD)
Entity type:Individual
Prefix:DR
First Name:ALFREDO
Middle Name:RAMON
Last Name:MAYORCA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:URBANIZACION EL PLANTIO
Mailing Address - Street 2:CALLE MAJAGUA A-130
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949
Mailing Address - Country:US
Mailing Address - Phone:561-618-2602
Mailing Address - Fax:
Practice Address - Street 1:URBANIZACION EL PLANTIO
Practice Address - Street 2:CALLE MAJAGUA A-130
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:561-618-2602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-14
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJDCATEMP-005167208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice