Provider Demographics
NPI:1598892234
Name:MERLE, LYDIA A (M D)
Entity Type:Individual
Prefix:DR
First Name:LYDIA
Middle Name:A
Last Name:MERLE
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3071 AVE ALEJANDRINO
Mailing Address - Street 2:PMB 231
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-7035
Mailing Address - Country:US
Mailing Address - Phone:787-789-3220
Mailing Address - Fax:787-789-3220
Practice Address - Street 1:HOSPITAL HERMANOS MELENDEZ, INC.
Practice Address - Street 2:APARTADO 306
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00960
Practice Address - Country:US
Practice Address - Phone:787-622-8494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9313208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR8-1629OtherPROVIDER NUMBER