Provider Demographics
NPI:1518581495
Name:MEREK AND MIR LLC
Entity Type:Organization
Organization Name:MEREK AND MIR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUMMER
Authorized Official - Middle Name:
Authorized Official - Last Name:SIEVERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-804-2651
Mailing Address - Street 1:PO BOX 178
Mailing Address - Street 2:
Mailing Address - City:LAKE HELEN
Mailing Address - State:FL
Mailing Address - Zip Code:32744-0178
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:631 LAKE PEARL DR
Practice Address - Street 2:
Practice Address - City:LAKE HELEN
Practice Address - State:FL
Practice Address - Zip Code:32744-2540
Practice Address - Country:US
Practice Address - Phone:386-227-6050
Practice Address - Fax:386-217-6025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-05
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty