Provider Demographics
NPI:1669676979
Name:REYES MERCADO, LUIS ANGEL (MD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:ANGEL
Last Name:REYES MERCADO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:LUIS
Other - Middle Name:
Other - Last Name:REYES MERCADO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:COND. FRENCH PLAZA APTO 116 81 CALLE MAYAGUEZ
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00917
Mailing Address - Country:US
Mailing Address - Phone:787-619-9131
Mailing Address - Fax:
Practice Address - Street 1:CARR. 3 KM 8.3 AVE. 65 DE INFANTERIA
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00984
Practice Address - Country:US
Practice Address - Phone:787-757-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR26422 R207P00000X
TXP4804207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine