Provider Demographics
NPI:1699150250
Name:JOSE MONTES MERCADO C S P
Entity type:Organization
Organization Name:JOSE MONTES MERCADO C S P
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MONTES MERCADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-884-2888
Mailing Address - Street 1:PO BOX 858
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-0858
Mailing Address - Country:US
Mailing Address - Phone:787-884-2888
Mailing Address - Fax:787-884-2888
Practice Address - Street 1:MANATI MEDICAL PLZ
Practice Address - Street 2:CALLE JOSE CANDELAS #1 SUITE 108
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-5507
Practice Address - Country:US
Practice Address - Phone:787-884-2888
Practice Address - Fax:787-884-2888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-24
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty