Provider Demographics
NPI:1689121634
Name:MERCADO MILLAN, PAOLA CHRISTINA (MD)
Entity type:Individual
Prefix:
First Name:PAOLA
Middle Name:CHRISTINA
Last Name:MERCADO MILLAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1395 CALLE SAN RAFAEL
Mailing Address - Street 2:
Mailing Address - City:SANTURCE
Mailing Address - State:PR
Mailing Address - Zip Code:00909-2518
Mailing Address - Country:US
Mailing Address - Phone:787-999-7620
Mailing Address - Fax:
Practice Address - Street 1:1395 CALLE SAN RAFAEL # 20
Practice Address - Street 2:
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00909-2518
Practice Address - Country:US
Practice Address - Phone:787-999-7620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-07
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR34888207R00000X
PR390200000X
PR22258207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program