Provider Demographics
NPI:1487067914
Name:MERCED, HAYMAR
Entity type:Individual
Prefix:
First Name:HAYMAR
Middle Name:
Last Name:MERCED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 AVE LOS DOMINICOS # URB
Mailing Address - Street 2:CALLE 6 BLQ 20-3
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00957-6707
Mailing Address - Country:US
Mailing Address - Phone:787-484-9493
Mailing Address - Fax:
Practice Address - Street 1:1 RES SAN MARTIN # URB
Practice Address - Street 2:CALLE LUIS PARDO 1008
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924-4301
Practice Address - Country:US
Practice Address - Phone:787-484-9493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-02
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2571715343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)