Provider Demographics
NPI:1497810923
Name:MERCADO VARGAS, RU BEN LUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:RU BEN
Middle Name:LUIS
Last Name:MERCADO VARGAS
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:B7 CALLE ARTURO R MUJICA
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-2140
Mailing Address - Country:US
Mailing Address - Phone:787-782-2988
Mailing Address - Fax:787-787-9905
Practice Address - Street 1:73 CALLE SANTA CRUZ
Practice Address - Street 2:SUITE 214 SANTA CRUZ MEDICAL
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6910
Practice Address - Country:US
Practice Address - Phone:787-798-4260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4777174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist