Provider Demographics
NPI:1962694695
Name:MERCADO, MERIDE
Entity type:Individual
Prefix:
First Name:MERIDE
Middle Name:
Last Name:MERCADO
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 1:241 TRUMBO RD
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-6684
Mailing Address - Country:US
Mailing Address - Phone:305-293-1400
Mailing Address - Fax:305-292-6701
Practice Address - Street 1:241 TRUMBO RD
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-6684
Practice Address - Country:US
Practice Address - Phone:305-293-1400
Practice Address - Fax:305-292-6701
Is Sole Proprietor?:No
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program