Provider Demographics
NPI:1013451152
Name:MERCURIUS, DELROY A (BEHAVIOR ASSISTANT)
Entity Type:Individual
Prefix:MR
First Name:DELROY
Middle Name:A
Last Name:MERCURIUS
Suffix:
Gender:M
Credentials:BEHAVIOR ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7965 SW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33068-2106
Mailing Address - Country:US
Mailing Address - Phone:954-290-0863
Mailing Address - Fax:
Practice Address - Street 1:7965 SW 6TH ST
Practice Address - Street 2:
Practice Address - City:NORTH LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33068-2106
Practice Address - Country:US
Practice Address - Phone:954-290-0863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-08
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst