Provider Demographics
NPI:1033876487
Name:MERCADO, YASMIN (ND)
Entity Type:Individual
Prefix:DR
First Name:YASMIN
Middle Name:
Last Name:MERCADO
Suffix:
Gender:F
Credentials:ND
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 2453
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00694-2453
Mailing Address - Country:US
Mailing Address - Phone:787-439-3032
Mailing Address - Fax:
Practice Address - Street 1:AVE TRIO VEGABAJENO
Practice Address - Street 2:#23
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693
Practice Address - Country:US
Practice Address - Phone:787-439-3032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR78175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath