Queency Joy Mercado, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

OS 12058 Issued in FL

Practice address

13241 Bartram Park Blvd
#209
Jacksonville, FL 32258-5212

Phone

(904) 242-4220

Fax

(904) 674-2313

NPI assigned

May 6, 2010

Last updated

Jan 23, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1273104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421971200000",
    "number": "1871811489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13241 BARTRAM PARK BLVD",
            "address_2": "#209",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585212",
            "telephone_number": "904-242-4220",
            "fax_number": "904-674-2313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13241 BARTRAM PARK BLVD",
            "address_2": "#209",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585212",
            "telephone_number": "904-242-4220",
            "fax_number": "904-674-2313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "QUEENCY",
        "middle_name": "JOY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-06",
        "last_updated": "2015-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "OS 12058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008835000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Ann Mentz
• Robert Theodore Mentz III, OTR/L
• Christopher Menz, ARNP
• Roger Micheel Menze, M.D.
• Diana Iniguez Mercado, M.D.
• Robert Mercado
• Theresa Lee Mercado
• Erica S. Mercer, MD
• Richard Mercer, APRN
• Teeya Mercer, MS

• Pediatrics Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.