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General NPI Number Information
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NPI Number | 1326233602
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Entity Type | Individual
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Provider Name | ALFREDO EDGARDO MERCADO-QUINONES M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/11/2007
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Last Update Date | 02/10/2021
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Provider Practice Location Address
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Address Line | 4980 SW 36TH LN
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City | OCALA
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State | FL
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Zip | 34474-9449
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Country | US
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Telephone | 939-539-7001
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Fax |
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Provider Business Mailing Address
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Address Line | 4980 SW 36TH LN
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City | OCALA
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State | FL
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Zip | 34474-9449
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Country | US
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Telephone |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME127312
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License Number State | FL
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