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NPI Code Detail

MEDICARE: KYLE IAN MERCADO

MEDICARE: KYLE IAN MERCADO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WC0200XCritical Care Medicine Registered Nurse279393SC

General Provider Information

NPI Number : 1205770823
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLE IAN MERCADO
Provider Business Mailing Address
First Line : 503 S TOWNVILLE ST
Second Line :
City : SENECA
State : SC
Zip : 29678-3926
Country : US
Telephone Number : 954-709-7977
Fax Number :
Provider Business Practice Location Address
First Line : 1 SAINT FRANCIS DR
Second Line :
City : GREENVILLE
State : SC
Zip : 29601-3955
Country : US
Telephone Number : 864-255-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2026
Last Update Date : 04/15/2026

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Directions to “ KYLE IAN MERCADO ” Practice Location

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