Provider Demographics
NPI:1811974496
Name:MERCADO/ALVARADO, JOANNA
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:MERCADO/ALVARADO
Suffix:
Gender:F
Credentials:
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 6022
Mailing Address - Street 2:PMB # 209
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00988-6022
Mailing Address - Country:US
Mailing Address - Phone:787-613-6169
Mailing Address - Fax:787-750-0930
Practice Address - Street 1:UPR HOSPITAL # 3 ROAD 65TH INFANTRY AVE.
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987
Practice Address - Country:US
Practice Address - Phone:787-757-1800
Practice Address - Fax:787-750-0930
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-27
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15353207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services