Provider Demographics
NPI:1467033027
Name:MERCADO SANTORI, ALEJANDRO ESTEBAN
Entity Type:Individual
Prefix:DR
First Name:ALEJANDRO
Middle Name:ESTEBAN
Last Name:MERCADO SANTORI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12631 E 17TH AVE STE C307
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-2527
Mailing Address - Country:US
Mailing Address - Phone:303-724-2302
Mailing Address - Fax:303-724-2300
Practice Address - Street 1:12631 E 17TH AVE STE C307
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2527
Practice Address - Country:US
Practice Address - Phone:303-724-2302
Practice Address - Fax:303-724-2300
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0008653390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program