Active NPI
Alexis Rodriguez Mercado, MD
- Internal Medicine Physician
- Lakeland, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME147354
- Practice address
- 4715 S Florida Ave Ste 200
Lakeland, FL 33813-2101 - Phone
- (863) 209-7004
- Fax
- (863) 274-3542
- NPI assigned
- Jul 13, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | ME147354 | FL | Primary |
Addresses
Primary practice location
4715 S Florida Ave Ste 200
Lakeland, FL 33813-2101
Mailing address
4715 S Florida Ave Ste 200
Lakeland, FL 33813-2101
Phone (863) 209-7004
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME147354 | FL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dedicated Senior Medical Center of Florida, LLC | Current | Accepting new patients | |
| Dedicated Senior Medical Center of Florida, LLC | Current | Accepting new patients |
Locations
4715 S Florida Ave
Ste 200
Lakeland, FL 33813
Phone (863) 209-7004
4715 S Florida Ave
Lakeland, FL 33813
Phone (863) 209-7003
206 N Florida Ave
Lakeland, FL 33801
Phone (863) 209-7003
1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Specialist
- Miami Gardens, FL
- NPI 1881055366
-
- Specialist
- Tampa, FL
- NPI 1700393881
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602806400000",
"number": "1083067110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4715 S FLORIDA AVE STE 200",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338132101",
"telephone_number": "863-209-7004",
"fax_number": "863-274-3542"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4715 S FLORIDA AVE STE 200",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338132101",
"telephone_number": "863-209-7004",
"fax_number": "863-274-3542"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ MERCADO",
"first_name": "ALEXIS",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-07-13",
"last_updated": "2020-10-16",
"certification_date": "2020-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME147354",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.