MEDICARE: HECTOR MERCADO NP

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	363LF0000X	Family Nurse Practitioner	APRN3395132	FL
2	363L00000X	Nurse Practitioner	ARNP3395132	FL

General Provider Information

NPI Number	:	1821077967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HECTOR MERCADO NP

Provider Business Mailing Address
First Line	:	PO BOX 534221
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30353-4221
Country	:	US
Telephone Number	:	305-651-2270
Fax Number	:	904-346-0113

Provider Business Practice Location Address
First Line	:	1611 NW 12TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33136-1096
Country	:	US
Telephone Number	:	305-585-1111
Fax Number	:

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

Provider Enumeration Date	:	01/16/2006
Last Update Date	:	03/27/2023

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Directions to “ HECTOR MERCADO NP” Practice Location

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