Healthcare Provider Details

I. General information

NPI: 1245264597
Provider Name (Legal Business Name): MERCY L SERALDE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 01/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 MEDICAL WAY SUITE 101
SEBRING FL
33870-5412
US

IV. Provider business mailing address

3201 MEDICAL WAY SUITE 101
SEBRING FL
33870-5412
US

V. Phone/Fax

Practice location:
  • Phone: 863-382-0566
  • Fax: 863-471-9340
Mailing address:
  • Phone: 863-382-0566
  • Fax: 863-471-9340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME42039
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: