Provider Demographics
NPI:1043271398
Name:MARIANO MERCEDES, VICOTR JULIO (MD)
Entity Type:Individual
Prefix:
First Name:VICOTR
Middle Name:JULIO
Last Name:MARIANO MERCEDES
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:MQ10 PLAZA 37
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-3577
Mailing Address - Country:US
Mailing Address - Phone:787-786-8912
Mailing Address - Fax:787-858-0434
Practice Address - Street 1:CALLE JOSE JULIAN ACOSTA
Practice Address - Street 2:#48
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00963
Practice Address - Country:US
Practice Address - Phone:787-858-0434
Practice Address - Fax:787-858-0434
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist