Provider Demographics
NPI:1710478201
Name:ESPIRITU, MARIA THERESA MERCADO (APRN)
Entity Type:Individual
Prefix:
First Name:MARIA THERESA
Middle Name:MERCADO
Last Name:ESPIRITU
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4638 SUN N LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33872-2176
Mailing Address - Country:US
Mailing Address - Phone:863-386-0055
Mailing Address - Fax:863-386-0118
Practice Address - Street 1:4638 SUN N LAKE BLVD
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33872
Practice Address - Country:US
Practice Address - Phone:863-386-0055
Practice Address - Fax:863-386-0118
Is Sole Proprietor?:No
Enumeration Date:2018-05-21
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9255125363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily