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Michael Mercandetti

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NPI Number Detailed Information

Provider Information:

Name: Michael Mercandetti
Gender: M
Provider License Number If Given: ME64173

NPI Information:

NPI: 1669471959
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 7/19/2005

Last Update Date: 10/1/2014

Provider Business Mailing Address:

Address: 5824 BEE RIDGE RD PMB 447
Sarasota, FL 34233
Phone Number: 9414887117
Fax Number: 9414882370

Provider Business Practice Location Address:

Address: 1499 E VENICE AVE
Venice, FL 34292
Phone Number: 9414887117
Fax Number: 9414882370

Provider Taxonomy:

Primary: 207W00000X
Secondary (if any):
State: FL

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