Provider Demographics
NPI:1487875183
Name:MERCADO, LIMARY (MPT)
Entity type:Individual
Prefix:MRS
First Name:LIMARY
Middle Name:
Last Name:MERCADO
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 CALLE LAUREL
Mailing Address - Street 2:VISTAS DE RIO GRANDE I
Mailing Address - City:RIO GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00745-9713
Mailing Address - Country:US
Mailing Address - Phone:787-206-5431
Mailing Address - Fax:
Practice Address - Street 1:152 CALLE LAUREL
Practice Address - Street 2:VISTAS DE RIO GRANDE I
Practice Address - City:RIO GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00745-9713
Practice Address - Country:US
Practice Address - Phone:787-206-5431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9372251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics