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General NPI Number Information
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NPI Number | 1205770823
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Entity Type | Individual
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Provider Name | KYLE IAN MERCADO
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Gender | Male
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Dates
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Enumeration Date | 04/15/2026
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Last Update Date | 04/15/2026
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Provider Practice Location Address
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Address Line | 1 SAINT FRANCIS DR
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City | GREENVILLE
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State | SC
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Zip | 29601-3955
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Country | US
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Telephone | 864-255-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 503 S TOWNVILLE ST
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City | SENECA
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State | SC
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Zip | 29678-3926
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Country | US
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Telephone | 954-709-7977
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 279393
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License Number State | SC
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