Provider Demographics
NPI:1356025548
Name:MERCADO, MELISSA E (APRN)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:E
Last Name:MERCADO
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 1:27637 US HIGHWAY 27
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-9033
Mailing Address - Country:US
Mailing Address - Phone:352-326-6001
Mailing Address - Fax:352-315-0235
Practice Address - Street 1:27637 US HIGHWAY 27
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-9033
Practice Address - Country:US
Practice Address - Phone:352-326-6001
Practice Address - Fax:352-315-0235
Is Sole Proprietor?:No
Enumeration Date:2023-06-09
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN1126601363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily