Healthcare Provider Details

I. General information

NPI: 1033044912
Provider Name (Legal Business Name): PRISCILLA MERCADO MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18940 NW 10TH ST
PEMBROKE PINES FL
33029-2927
US

IV. Provider business mailing address

18940 NW 10TH ST
PEMBROKE PINES FL
33029-2927
US

V. Phone/Fax

Practice location:
  • Phone: 786-351-8916
  • Fax:
Mailing address:
  • Phone: 786-351-8916
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11031066
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: