Provider Demographics
NPI:1962596437
Name:MERCER, JASON REED (MD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:REED
Last Name:MERCER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:801 BEVILLE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SOUTH DAYTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32119-1860
Mailing Address - Country:US
Mailing Address - Phone:386-322-5200
Mailing Address - Fax:386-767-0062
Practice Address - Street 1:801 BEVILLE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:SOUTH DAYTONA
Practice Address - State:FL
Practice Address - Zip Code:32119-1860
Practice Address - Country:US
Practice Address - Phone:386-322-5200
Practice Address - Fax:386-767-0062
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2011-12-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME60900207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL372544800Medicaid
FL372544800Medicaid
FLF08119Medicare UPIN