Provider Demographics
NPI:1275151698
Name:GONZALEZ MERCADO, MARANGELY
Entity Type:Individual
Prefix:
First Name:MARANGELY
Middle Name:
Last Name:GONZALEZ MERCADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 4 BOX 49000
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-8506
Mailing Address - Country:US
Mailing Address - Phone:787-403-6029
Mailing Address - Fax:
Practice Address - Street 1:CALLE DANIEL NIEVES ADAMES BO. NARANJITO
Practice Address - Street 2:
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659
Practice Address - Country:US
Practice Address - Phone:787-403-6029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-13
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program