Provider Demographics
NPI:1942906649
Name:MERCADO VEIN SOLUTIONS S CORPORATION
Entity Type:Organization
Organization Name:MERCADO VEIN SOLUTIONS S CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:MERCADO
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:347-742-7605
Mailing Address - Street 1:1501 PRESIDENTIAL WAY STE 21
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-1852
Mailing Address - Country:US
Mailing Address - Phone:561-227-9237
Mailing Address - Fax:561-923-8171
Practice Address - Street 1:1501 PRESIDENTIAL WAY STE 21
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-1852
Practice Address - Country:US
Practice Address - Phone:561-227-9237
Practice Address - Fax:561-923-8171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-03
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebologyGroup - Single Specialty