Provider Demographics
NPI:1649060468
Name:MERCADO, TRINIDEE
Entity type:Individual
Prefix:
First Name:TRINIDEE
Middle Name:
Last Name:MERCADO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16227 BRIDGEPARK DR
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-4875
Mailing Address - Country:US
Mailing Address - Phone:813-817-0899
Mailing Address - Fax:
Practice Address - Street 1:121 W PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-3429
Practice Address - Country:US
Practice Address - Phone:386-258-1618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program