Provider Demographics
NPI:1104623727
Name:MERCALDI, MACARIA
Entity type:Individual
Prefix:
First Name:MACARIA
Middle Name:
Last Name:MERCALDI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16728 SHIRLA RAE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34610-7745
Mailing Address - Country:US
Mailing Address - Phone:954-257-2191
Mailing Address - Fax:
Practice Address - Street 1:924 HALE AVE STE 107
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34601-3642
Practice Address - Country:US
Practice Address - Phone:813-748-7571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-01
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24387075106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst