Individual
DR. CONNIE K. MERCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
201 LAGRANDE BLVD, LADY LAKE, FL 32159-1303
(352) 753-0606
(352) 753-0650
Mailing address
201 LAGRANDE BLVD, LADY LAKE, FL 32159-1303
(352) 753-0606
(352) 753-0650
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME69236
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080112357
RAILROAD MEDICARE NUMBER
FL
05
—
257176500
—
FL
Enumeration date
06/05/2006
Last updated
02/06/2023
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