Individual provider Active NPI

Mercedes Condom, APRN

  • Family Nurse Practitioner
  • South Miami, FL
National Provider Identifier
1831062009
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11042414 Issued in FL
Practice address
6240 SW 58TH St
South Miami, FL 33143-2104
Phone
(305) 992-3422
NPI assigned
Sep 24, 2025
Last updated
Sep 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 11042414 FL Primary

Addresses

Primary practice location

6240 SW 58TH St
South Miami, FL 33143-2104

Mailing address

6240 SW 58TH St
South Miami, FL 33143-2104
Phone (305) 992-3422

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260128004340 FL Practitioner - Nurse Practitioner 8224516547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6240 SW 58TH St
South Miami, FL 33143-2104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11042414FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Merbella Primary Care & Wellness LLC Single Specialty CurrentSince Dec 5, 2025 Accepting new patients

Organizations & group practices 1

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": "1758672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1831062009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6240 SW 58TH ST",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331432104",
            "telephone_number": "305-992-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6240 SW 58TH ST",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331432104",
            "telephone_number": "305-992-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDOM",
        "first_name": "MERCEDES",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-24",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11042414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

Verify at the official NPI Registry.