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Individual

IDALIS MERCADO NEGRON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MPHE, CTTS, CHES

Contact information

Practice address
CALLE FELIPE DE PLANA #5, GUAYNABO, PR 00966
(787) 999-6200
Mailing address
138 AVE WINSTON CHURCHILL, SAN JUAN, PR 00926-6013
(787) 999-6200

Taxonomy

Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
16160
PR
225200000X
Physical Therapy Assistant
1504
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16160
CHES
PR
Enumeration date
09/25/2019
Last updated
04/14/2022
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