1568497949 NPI number — DR. MIGUEL PALACIOS-MERCADO M.D.

Table of content: DR. MIGUEL PALACIOS-MERCADO M.D. (NPI 1568497949)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568497949 NPI number — DR. MIGUEL PALACIOS-MERCADO M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PALACIOS-MERCADO
Provider First Name:
MIGUEL
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568497949
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/15/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 5549
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAGUAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00726-5549
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-743-1415
Provider Business Mailing Address Fax Number:
787-961-4609

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HIMA PLAZA 1
Provider Second Line Business Practice Location Address:
500 AVE. DEGETAU, STE. 415
Provider Business Practice Location Address City Name:
CAGUAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00725-7301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-743-1415
Provider Business Practice Location Address Fax Number:
787-961-4609
Provider Enumeration Date:
07/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  6879 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 660580610 . This is a "PREFERRED MEDICARE CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6250094 . This is a "HUMANA INSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 660580610 . This is a "SALUD PORADICON MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 90414 . This is a "SSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 27643 . This is a "MEDICARE OPTIMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 660580610 . This is a "AARP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 660580610 . This is a "COSVIMED" identifier . This identifiers is of the category "OTHER".
  • Identifier: 68486 . This is a "CRUZ AZUL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 90414 . This is a "MEDICARE OPTIMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 27643 . This is a "SSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6250094 . This is a "HUMANA HEALTH PLANS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 660580610 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 110074865 . This is a "PALMETTO GBA RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 660580610 . This is a "MEDICAL CARD SYSTEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 660580610 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 660580610 . This is a "MCS CLASSICARE" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com