MEDICARE: MERCEDES LLAMA ESTEVEZ APRN

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	363L00000X	Nurse Practitioner	11017436	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750042131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MERCEDES LLAMA ESTEVEZ APRN

Provider Business Mailing Address
First Line	:	PO BOX 3445
Second Line	:
City	:	NORTH FORT MYERS
State	:	FL
Zip	:	33918-3445
Country	:	US
Telephone Number	:	239-369-3333
Fax Number	:	239-369-4837

Provider Business Practice Location Address
First Line	:	2625 LEE BLVD STE 100
Second Line	:
City	:	LEHIGH ACRES
State	:	FL
Zip	:	33971-1569
Country	:	US
Telephone Number	:	239-369-3333
Fax Number	:	239-369-4837

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2022
Last Update Date	:	05/03/2024

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