Individual provider Active NPI

Carlos Mercado, M.D.

  • Family Medicine Physician
  • Lake Mary, FL
National Provider Identifier
1033139100
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME 73229 Issued in FL
Practice address
1307 S International Pkwy
Suite 2091
Lake Mary, FL 32746-1413
Phone
(407) 771-0404
Fax
(407) 771-0405
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME 73229 FL Primary
Geriatric Medicine (Family Medicine) Physician 207QG0300X ME 73229 FL

Addresses

Primary practice location

1307 S International Pkwy
Suite 2091
Lake Mary, FL 32746-1413

Mailing address

1307 S. International Pkwy
Suite 2091
Lake Mary, FL 32746-1414
Phone (407) 771-0404

Other practice location 1

4270 Aloma Ave Ste 104
Winter Park, FL 32792-9366
Phone (321) 788-2777

Other identifiers 1

IdentifierTypeStateIssuer
259497800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090612000255 FL Practitioner - Family Practice 3274683248 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 73229FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Inpatient Medicine LLC CurrentSince Mar 25, 2009 Accepting new patients
Eternamd Past Accepting new patients

Locations

525 Technology Park
Ste 109
Lake Mary, FL 32746
Phone 4076472346 ext. 111

2180 W State Road 434
Ste 2110
Longwood, FL 32779
Phone (407) 488-0515

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1033139100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 S. INTERNATIONAL PKWY",
            "address_2": "SUITE 2091",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327461414",
            "telephone_number": "407-771-0404",
            "fax_number": "407-771-0405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 S INTERNATIONAL PKWY",
            "address_2": "SUITE 2091",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327461413",
            "telephone_number": "407-771-0404",
            "fax_number": "407-771-0405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4270 Aloma Ave Ste 104",
            "address_purpose": "LOCATION",
            "city": "Winter Park",
            "state": "FL",
            "postal_code": "327929366",
            "country_code": "US",
            "telephone_number": "321-788-2777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "CARLOS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 73229",
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME 73229",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259497800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.