Healthcare Provider Details

I. General information

NPI: 1235506270
Provider Name (Legal Business Name): MR. DANIEL MERCADO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DANIEL MERCADO ARNP

II. Dates (important events)

Enumeration Date: 08/25/2015
Last Update Date: 11/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86 W UNDERWOOD ST MP 80
ORLANDO FL
32806-2008
US

IV. Provider business mailing address

86 W UNDERWOOD ST MP 80
ORLANDO FL
32806-2008
US

V. Phone/Fax

Practice location:
  • Phone: 321-843-5270
  • Fax: 321-843-5177
Mailing address:
  • Phone: 321-843-5270
  • Fax: 321-843-5177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberARNP3223622
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: