Provider Demographics
NPI:1982633210
Name:RODRIGUEZ-MERCADO, RAFAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:
Last Name:RODRIGUEZ-MERCADO
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:PO BOX 363185
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-3185
Mailing Address - Country:US
Mailing Address - Phone:787-754-0101
Mailing Address - Fax:787-792-7640
Practice Address - Street 1:UNIVERSITY OF PUERTO RICO MEDICAL SCIENCES CAMPUS
Practice Address - Street 2:NEUROSURGERY DEPARTMENT BO MONACILLOS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-758-2525
Practice Address - Fax:787-792-7640
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10563207T00000X, 2085N0700X, 2085R0204X
NY198236207T00000X, 2085N0700X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC 83172Medicare UPIN