MEDICARE: DR. JASON REED MERCER M.D.

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	207Q00000X	Family Medicine Physician	ME60900	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

General Provider Information

NPI Number	:	1962596437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON REED MERCER M.D.

Provider Business Mailing Address
First Line	:	801 BEVILLE RD
Second Line	:	SUITE 201
City	:	SOUTH DAYTONA
State	:	FL
Zip	:	32119-1860
Country	:	US
Telephone Number	:	386-322-5200
Fax Number	:	386-767-0062

Provider Business Practice Location Address
First Line	:	801 BEVILLE RD
Second Line	:	SUITE 201
City	:	SOUTH DAYTONA
State	:	FL
Zip	:	32119-1860
Country	:	US
Telephone Number	:	386-322-5200
Fax Number	:	386-767-0062

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

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	12/28/2011

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