Provider Demographics
NPI:1811612716
Name:MERCADO GONZALEZ, FRANCISCO (MD)
Entity type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:
Last Name:MERCADO GONZALEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 BLUE LAGOON DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3168
Mailing Address - Country:US
Mailing Address - Phone:305-500-2000
Mailing Address - Fax:
Practice Address - Street 1:4850 W OAKLAND PARK BLVD STE 148
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33313-7277
Practice Address - Country:US
Practice Address - Phone:549-735-1200
Practice Address - Fax:877-553-1358
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-04
Last Update Date:2025-06-05
Deactivation Date:2024-01-26
Deactivation Code:
Reactivation Date:2024-01-30
Provider Licenses
StateLicense IDTaxonomies
FLACN1666208D00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice