Provider Demographics
NPI:1972618585
Name:VALCARCEL-MERCADO, CARMEN GEORGINA (MD)
Entity type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:GEORGINA
Last Name:VALCARCEL-MERCADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CARMEN
Other - Middle Name:G
Other - Last Name:VALCARCEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:131 AVE WINSTON CHURCHILL STE 2
Mailing Address - Street 2:CROWN HILLS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6012
Mailing Address - Country:US
Mailing Address - Phone:787-764-5642
Mailing Address - Fax:787-764-4959
Practice Address - Street 1:131 AVE WINSTON CHURCHILL
Practice Address - Street 2:SUITE B CROWN HILLS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-6012
Practice Address - Country:US
Practice Address - Phone:787-764-5642
Practice Address - Fax:787-764-4959
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13163207P00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine