Individual
MRS. MYLENE MERCADO ANTONIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
111 DOCTOR CIR, COLUMBIA, SC 29203-6502
(800) 491-0909
Mailing address
111 DOCTOR CIR, COLUMBIA, SC 29203-6502
(800) 491-0909
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
22669
SC
Other
Enumeration date
01/07/2020
Last updated
10/31/2022
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