Provider Demographics
NPI:1013011436
Name:CORTES-MERCADO, MILAGRO (MD)
Entity Type:Individual
Prefix:
First Name:MILAGRO
Middle Name:
Last Name:CORTES-MERCADO
Suffix:
Gender:F
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:PO BOX 51396
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00950-1396
Mailing Address - Country:US
Mailing Address - Phone:787-784-4068
Mailing Address - Fax:787-784-4069
Practice Address - Street 1:HA2 CALLE ANTONIO PAOLI
Practice Address - Street 2:SEPTIMA SECCION
Practice Address - City:LEVITTOWN
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-784-4068
Practice Address - Fax:787-784-4069
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13573207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH41624Medicare ID - Type Unspecified