MEDICARE: DR. LAUREN MERCURIO

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	225100000X	Physical Therapist	1272600	TX
2	2251X0800X	Orthopedic Physical Therapist	PT015462	OH

General Provider Information

NPI Number	:	1699138461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAUREN MERCURIO

Provider Business Mailing Address
First Line	:	595 PARKSIDE DR
Second Line	:
City	:	BAY VILLAGE
State	:	OH
Zip	:	44140-2552
Country	:	US
Telephone Number	:	614-593-1336
Fax Number	:

Provider Business Practice Location Address
First Line	:	23550 CENTER RIDGE RD STE 516
Second Line	:
City	:	WESTLAKE
State	:	OH
Zip	:	44145-3655
Country	:	US
Telephone Number	:	440-895-9770
Fax Number	:

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

Provider Enumeration Date	:	03/30/2016
Last Update Date	:	11/19/2024

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Directions to “ DR. LAUREN MERCURIO ” Practice Location

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