Provider Demographics
NPI:1912928573
Name:BAYAMON PEDIATRIC PULMONARY SERVICES
Entity Type:Organization
Organization Name:BAYAMON PEDIATRIC PULMONARY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEJANDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:MERCADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-786-8800
Mailing Address - Street 1:1845 CARR. # 2 BAYAMON MEDICAL PLAZA
Mailing Address - Street 2:SUITE # 305
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-7203
Mailing Address - Country:US
Mailing Address - Phone:787-786-8800
Mailing Address - Fax:787-999-5823
Practice Address - Street 1:1845 CARR. # 2 BAYAMON MEDICAL PLAZA
Practice Address - Street 2:SUITE # 305
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-7203
Practice Address - Country:US
Practice Address - Phone:787-786-8800
Practice Address - Fax:787-999-5823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR63712080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric PulmonologyGroup - Single Specialty