MEDICARE: ANGELICA MERCADO ARNP

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	363L00000X	Nurse Practitioner	ARNP9285214	FL
2	363LF0000X	Family Nurse Practitioner	APRN9285214	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720423924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELICA MERCADO ARNP

Provider Business Mailing Address
First Line	:	11200 SW 8TH STREET STUDENT HEALTH SERVICES
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33199-0001
Country	:	US
Telephone Number	:	305-348-3437
Fax Number	:	305-348-0336

Provider Business Practice Location Address
First Line	:	11200 SW 8TH ST STUDENT HEALTH CENTER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33199-1828
Country	:	US
Telephone Number	:	305-348-2401
Fax Number	:

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

Provider Enumeration Date	:	05/02/2013
Last Update Date	:	05/07/2021

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