MEDICARE: JAMILA R MERCADO SLPA

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
1	2355S0801X	Speech-Language Assistant	SI2837	FL

General Provider Information

NPI Number	:	1528563004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMILA R MERCADO SLPA

Provider Business Mailing Address
First Line	:	20021 NW 12TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33169-2713
Country	:	US
Telephone Number	:	786-659-5022
Fax Number	:

Provider Business Practice Location Address
First Line	:	735 NW 22ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125-3381
Country	:	US
Telephone Number	:	786-953-7130
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2018
Last Update Date	:	03/27/2018

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Directions to “ JAMILA R MERCADO SLPA” Practice Location

Language	Start Address	Practice Location

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