# MICHAEL MERCANDETTI MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376783407
- **Authorized official:** MICHAEL MERCANDETTI M.D. (PHYSICIAN)
- **Authorized official phone:** (941) 584-4039

## Contact information

- **Practice address:** 1499 E VENICE AVE UNIT B, VENICE, FL 34292-3207
- **Practice address phone:** (941) 584-4039
- **Practice address fax:** (941) 375-0097
- **Mailing address:** 1499 E VENICE AVE UNIT B, VENICE, FL 34292-3207
- **Mailing address phone:** (941) 584-4039
- **Mailing address fax:** (941) 375-0097

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 03/03/2009
- **Last updated:** 04/05/2024