Provider Demographics
NPI:1174992069
Name:MERCED, YANIRA
Entity type:Individual
Prefix:
First Name:YANIRA
Middle Name:
Last Name:MERCED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARR EST 3 KM 78.0
Mailing Address - Street 2:PLAZA PALMA REAL
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791
Mailing Address - Country:US
Mailing Address - Phone:787-656-9410
Mailing Address - Fax:787-852-9650
Practice Address - Street 1:CARR EST 3 KM 78.0
Practice Address - Street 2:PLAZA PALMA REAL
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791
Practice Address - Country:US
Practice Address - Phone:787-656-9410
Practice Address - Fax:787-852-9650
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2965183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician