Basic Information
| Provider Information | |||||||||
| NPI: | 1003407172 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MERCEDES ENCARNACION | ||||||||
| FirstName: | TORIBIO | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5400 PINEHURST DR | ||||||||
| Address2: | |||||||||
| City: | SPRING HILL | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346063833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3522775348 | ||||||||
| FaxNumber: | 3526062857 | ||||||||
| Practice Location | |||||||||
| Address1: | 5350 SPRING HILL DR | ||||||||
| Address2: | |||||||||
| City: | SPRING HILL | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346064562 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3526883379 | ||||||||
| FaxNumber: | 3523981333 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2021 | ||||||||
| LastUpdateDate: | 09/15/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 022175 | PR | N | Allopathic & Osteopathic Physicians | General Practice | 208D00000X | ACN1377 | FL | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.