Provider Demographics
NPI:1851353817
Name:MEJIAS, GERARDO A (MD)
Entity Type:Individual
Prefix:DR
First Name:GERARDO
Middle Name:A
Last Name:MEJIAS
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 1:155 CALLE SOCORRO
Mailing Address - Street 2:
Mailing Address - City:QUEBRADILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00678-1830
Mailing Address - Country:US
Mailing Address - Phone:787-895-3431
Mailing Address - Fax:
Practice Address - Street 1:155 CALLE SOCORRO
Practice Address - Street 2:
Practice Address - City:QUEBRADILLAS
Practice Address - State:PR
Practice Address - Zip Code:00678-1830
Practice Address - Country:US
Practice Address - Phone:787-895-3431
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15804146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRI28943Medicare UPIN