Provider Demographics
NPI:1376025619
Name:MERCADO-COLON, LOUIE JAVIER (DC)
Entity Type:Individual
Prefix:DR
First Name:LOUIE
Middle Name:JAVIER
Last Name:MERCADO-COLON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ESTANCIAS DEL GOLF CLUB
Mailing Address - Street 2:386 JUAN H CINTRON
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730
Mailing Address - Country:US
Mailing Address - Phone:787-393-3310
Mailing Address - Fax:
Practice Address - Street 1:623 AVE LA CEIBA
Practice Address - Street 2:STE 203
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1902
Practice Address - Country:US
Practice Address - Phone:787-393-3310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-04
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR654111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor