Basic Information
| Provider Information | |||||||||
| NPI: | 1245874478 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VARGAS MERCADO | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | I | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 193069 | ||||||||
| Address2: | |||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009193069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877610036 | ||||||||
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| Practice Location | |||||||||
| Address1: | STREET NUM 2 KM 48.3 | ||||||||
| Address2: | STREET JOSE CANDELAS OFFICE NUM 203 MANATI MEDICAL MALL | ||||||||
| City: | MANATI | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00674 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878844629 | ||||||||
| FaxNumber: | 7872925050 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/31/2019 | ||||||||
| LastUpdateDate: | 10/31/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 1015 | PR | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.