Provider Demographics
NPI:1134778947
Name:RAMIREZ MERCADO, JAN LUIS (MD)
Entity type:Individual
Prefix:DR
First Name:JAN
Middle Name:LUIS
Last Name:RAMIREZ 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:MANS DE SAN GERMAN D5 CALLE 4
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-4675
Mailing Address - Country:US
Mailing Address - Phone:787-395-0748
Mailing Address - Fax:
Practice Address - Street 1:URB. MANSIONES DE SAN GERMAN D5 CALLE 4
Practice Address - Street 2:
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-4675
Practice Address - Country:US
Practice Address - Phone:787-395-0748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-05
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22733208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice