Basic Information
| Provider Information | |||||||||
| NPI: | 1578299269 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MERCED | ||||||||
| FirstName: | MARISOL | ||||||||
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| Credential: | RN,BSN | ||||||||
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| Mailing Information | |||||||||
| Address1: | VILLAS DE CARRAIZO | ||||||||
| Address2: | CALLE 46 P43 | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009269172 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7876073575 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 668 CALLE CUBITAS | ||||||||
| Address2: | |||||||||
| City: | GUAYNABO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009692801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877877733 | ||||||||
| FaxNumber: | 7872690022 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2022 | ||||||||
| LastUpdateDate: | 07/26/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 018271 | PR | Y | Nursing Service Providers | Registered Nurse |
No ID Information.