Healthcare Provider Details

I. General information

NPI: 1336024181
Provider Name (Legal Business Name): KAYLEE MERCADO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2025
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 SW 62ND AVE STE 300
SOUTH MIAMI FL
33143-4719
US

IV. Provider business mailing address

7000 SW 62ND AVE STE 300
SOUTH MIAMI FL
33143-4719
US

V. Phone/Fax

Practice location:
  • Phone: 305-665-6501
  • Fax:
Mailing address:
  • Phone: 305-665-6501
  • Fax: 786-536-7778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN11041361
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: