Provider Demographics
NPI:1831640150
Name:GARCIA, MERCEDES (ARNP,FNP)
Entity Type:Individual
Prefix:MISS
First Name:MERCEDES
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:ARNP,FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 W 44TH PL APT 212
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-7402
Mailing Address - Country:US
Mailing Address - Phone:786-370-1740
Mailing Address - Fax:
Practice Address - Street 1:4578 W 12TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3325
Practice Address - Country:US
Practice Address - Phone:305-828-1989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-21
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9303206363LF0000X
FLAPRN9303206363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022988700Medicaid