Provider Demographics
NPI:1093836108
Name:MERCADO, CARMEN TERESA (MD)
Entity Type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:TERESA
Last Name: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:CARIBBEAN MEDICAL CENTRE
Mailing Address - Street 2:SUITE 2312-3
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717
Mailing Address - Country:US
Mailing Address - Phone:787-231-7697
Mailing Address - Fax:
Practice Address - Street 1:2279 PONCE BY PASS
Practice Address - Street 2:CARIBEAN MEDICAL CENTRE SUITE 2312-2
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717
Practice Address - Country:US
Practice Address - Phone:787-231-7697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8857208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics