Provider Demographics
NPI:1902378342
Name:RMERCADOMD, LLC
Entity Type:Organization
Organization Name:RMERCADOMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:RAQUEL
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MERCADO SEPULVEDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-591-9073
Mailing Address - Street 1:5950 E ROSEWOOD STREET
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-1535
Mailing Address - Country:US
Mailing Address - Phone:520-347-5662
Mailing Address - Fax:520-347-5895
Practice Address - Street 1:1500 NORTH WILMOT ROAD
Practice Address - Street 2:#C-260
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-4416
Practice Address - Country:US
Practice Address - Phone:520-347-5662
Practice Address - Fax:520-347-5895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-26
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty