Provider Demographics
NPI:1013128198
Name:MERCADO, OSCAR E
Entity Type:Individual
Prefix:MR
First Name:OSCAR
Middle Name:E
Last Name:MERCADO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:A3 CALLE AZAHAR
Mailing Address - Street 2:VISTAS DE GUAYNABO
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5442
Mailing Address - Country:US
Mailing Address - Phone:787-789-5274
Mailing Address - Fax:
Practice Address - Street 1:CARR #2 KM 19.5
Practice Address - Street 2:BO. CANDELARIA
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-251-2323
Practice Address - Fax:787-251-7012
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2736183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist