Provider Demographics
NPI:1124055892
Name:RAMOS-MERCADO, MIRIAN (MD)
Entity type:Individual
Prefix:DR
First Name:MIRIAN
Middle Name:
Last Name:RAMOS-MERCADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:894 CALLE ESPIONCELA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924-2373
Mailing Address - Country:US
Mailing Address - Phone:787-745-8385
Mailing Address - Fax:787-745-8385
Practice Address - Street 1:V40 AVE LUIS MUNOZ MARIN
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-6462
Practice Address - Country:US
Practice Address - Phone:787-745-8385
Practice Address - Fax:787-745-8385
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11269174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist