Provider Demographics
NPI:1831130624
Name:VIELOT, MERCIE (ARNP)
Entity Type:Individual
Prefix:
First Name:MERCIE
Middle Name:
Last Name:VIELOT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5010 HOLLYWOOD BLVD
Mailing Address - Street 2:100B
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6516
Mailing Address - Country:US
Mailing Address - Phone:954-967-0028
Mailing Address - Fax:954-967-8141
Practice Address - Street 1:168 N POWERLINE RD
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-5713
Practice Address - Country:US
Practice Address - Phone:954-970-8805
Practice Address - Fax:954-582-0556
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3199082363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL306525100Medicaid
FLU3869OtherBCBS
FL277022OtherWELLCARE
FL306525100Medicaid
FL277022OtherWELLCARE