Provider Demographics
NPI:1851851026
Name:COLON-MERCADO, OLGA MARIE (MD)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:MARIE
Last Name:COLON-MERCADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 748817
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-8817
Mailing Address - Country:US
Mailing Address - Phone:813-286-0033
Mailing Address - Fax:813-282-0033
Practice Address - Street 1:515 S KINGS AVE STE 3000
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-6060
Practice Address - Country:US
Practice Address - Phone:813-681-6625
Practice Address - Fax:813-684-6043
Is Sole Proprietor?:No
Enumeration Date:2019-03-22
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME163773207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program