Provider Demographics
NPI:1982738035
Name:NAIDA MERCADO
Entity Type:Organization
Organization Name:NAIDA MERCADO
Other - Org Name:LABORATORIO CLINICO NAIDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NAIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MERCADO
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-873-2721
Mailing Address - Street 1:CALLE FRANCISCO M QUINONES 23
Mailing Address - Street 2:
Mailing Address - City:SABANA GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00637-1942
Mailing Address - Country:US
Mailing Address - Phone:787-873-2721
Mailing Address - Fax:787-873-2557
Practice Address - Street 1:CALLE FRANCISCO M QUINONES 23
Practice Address - Street 2:
Practice Address - City:SABANA GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00637-1942
Practice Address - Country:US
Practice Address - Phone:787-873-2721
Practice Address - Fax:787-873-2557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR680291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0038307Medicare PIN