Mercedes Lopez Taveras, MD

Individual provider Active NPI Obstetrics & Gynecology Physician · Ciales, PR

NPI 1972571396 · NPPES record last updated Jan 24, 2011

Key facts

NPI
1972571396
Entity type
Individual (NPI type 1)
Primary specialty
Obstetrics & Gynecology Physician 207V00000X
License
5073 (PR)
Practice address
Road 149 KM 12.3
Ciales, PR 00638
Phone
(787) 871-0601
Fax
(787) 871-3960
NPI assigned
Mar 10, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5073PRMDPharmacy Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 5073 PR Yes

Addresses

Primary practice location

Road 149 KM 12.3
Ciales, PR 00638

Mailing address

PO Box 1427
Ciales, PR 00638-1427
Phone (787) 871-0601

Other identifiers

IdentifierTypeStateIssuer
26405OtherPRMEDICAL SERVICE

Other providers in Ciales, PR

All providers in Ciales, PR · Obstetrics & Gynecology Physician in Puerto Rico

Sources for this page

Verify at the official NPI Registry.