MEDICARE: ENHANCED PSYCHIATRY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1215781539
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENHANCED PSYCHIATRY LLC

Provider Business Mailing Address
First Line	:	2903 W NEW HAVEN AVE # 591
Second Line	:
City	:	W MELBOURNE
State	:	FL
Zip	:	32904-3661
Country	:	US
Telephone Number	:	321-872-8443
Fax Number	:	321-621-0036

Provider Business Practice Location Address
First Line	:	586 ADDISON AVE NE
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32907-2499
Country	:	US
Telephone Number	:	321-872-8443
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MAXI INEZ MERCADO
Credential	:	PMHNP, B.C.
Telephone Number	:	321-872-8443

Provider Enumeration Date	:	04/15/2024
Last Update Date	:	04/07/2026

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