Provider Demographics
NPI:1043208432
Name:MERCADO RAMIREZ, DIAHNARA (MD)
Entity Type:Individual
Prefix:DR
First Name:DIAHNARA
Middle Name:
Last Name:MERCADO RAMIREZ
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 1750
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610-1750
Mailing Address - Country:US
Mailing Address - Phone:787-370-6187
Mailing Address - Fax:787-826-7411
Practice Address - Street 1:65 DE INFANTERIA 67
Practice Address - Street 2:SUITE 104-109
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610
Practice Address - Country:US
Practice Address - Phone:787-826-2145
Practice Address - Fax:787-826-7411
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-10
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16132208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR16132OtherLIC