Provider Demographics
NPI:1578299269
Name:MERCED, MARISOL (RN,BSN)
Entity Type:Individual
Prefix:
First Name:MARISOL
Middle Name:
Last Name:MERCED
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:VILLAS DE CARRAIZO
Mailing Address - Street 2:CALLE 46 P43
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-9172
Mailing Address - Country:US
Mailing Address - Phone:787-607-3575
Mailing Address - Fax:
Practice Address - Street 1:668 CALLE CUBITAS
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-2801
Practice Address - Country:US
Practice Address - Phone:787-787-7733
Practice Address - Fax:787-269-0022
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR018271163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse