Provider Demographics
NPI:1427038538
Name:MERCADO, RICHARD FLORIAN (DPM)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:FLORIAN
Last Name:MERCADO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2597 SW 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-2082
Mailing Address - Country:US
Mailing Address - Phone:305-553-4341
Mailing Address - Fax:305-553-2336
Practice Address - Street 1:2597 SW 87TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-2082
Practice Address - Country:US
Practice Address - Phone:305-553-4341
Practice Address - Fax:305-553-2336
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-17
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 2250213EP1101X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390085100Medicaid
U41245Medicare UPIN
65277Medicare ID - Type Unspecified