{"id":19,"date":"2018-06-14T11:19:45","date_gmt":"2018-06-14T11:19:45","guid":{"rendered":"https:\/\/www.toplinemd.com\/jaime-a-mercado-md\/?page_id=19"},"modified":"2023-06-12T11:29:08","modified_gmt":"2023-06-12T11:29:08","slug":"contact","status":"publish","type":"page","link":"https:\/\/www.toplinemd.com\/broward-complete-obgyn-wellness-center\/request-appointment\/","title":{"rendered":"Request an Appointment"},"content":{"rendered":"<p><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-parallax-none nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-background-position:center bottom;--awb-background-blend-mode:overlay;--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:10%;--awb-padding-bottom:10%;--awb-background-color:rgba(255,255,255,0.35);--awb-background-image:url(&quot;https:\/\/www.toplinemd.com\/wp-content\/uploads\/sites\/91\/2020\/07\/Contact-us.jpg&quot;);--awb-background-size:cover;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_5 1_5 fusion-one-fifth fusion-column-first\" style=\"--awb-bg-size:cover;width:20%;width:calc(20% - ( ( 4% + 4% ) * 0.2 ) );margin-right: 4%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_3_5 3_5 fusion-three-fifth fusion-animated\" style=\"--awb-padding-top:1px;--awb-bg-color:rgba(150,188,224,0.63);--awb-bg-color-hover:rgba(150,188,224,0.63);--awb-bg-size:cover;width:60%;width:calc(60% - ( ( 4% + 4% ) * 0.6 ) );margin-right: 4%;\" data-animationType=\"fadeInDown\" data-animationDuration=\"0.6\" data-animationOffset=\"top-into-view\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-title title fusion-title-1 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-one\" style=\"--awb-text-color:#ffffff;--awb-margin-top:30px;--awb-margin-bottom:30px;--awb-margin-top-small:20px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;\"><h1 class=\"fusion-title-heading title-heading-center fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:63;line-height:1.11;\">Request an Appointment<\/h1><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-2 fusion_builder_column_1_5 1_5 fusion-one-fifth fusion-column-last\" style=\"--awb-bg-size:cover;width:20%;width:calc(20% - ( ( 4% + 4% ) * 0.2 ) );\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2 has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:5%;--awb-padding-bottom:5%;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-3 fusion_builder_column_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"--awb-bg-size:cover;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-text fusion-text-1 fusion-text-no-margin\" style=\"--awb-margin-bottom:30px;\"><p style=\"text-align: center;\">When it comes to your healthcare, it\u2019s normal to have questions. Our team is ready to lend an ear, provide answers, or point you in the direction of the right provider.<\/p>\n<p style=\"text-align: center;\">By filling out your details below, you are not guaranteed an appointment. A member of our staff will be in contact with you to confirm your appointment time.<\/p>\n<\/div>\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f863-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"863\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/broward-complete-obgyn-wellness-center\/wp-json\/wp\/v2\/pages\/19#wpcf7-f863-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"863\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.6\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f863-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/fieldset>\n<div class=\"app-form\">\n\t<div class=\"section1\">\n\t\t<div class=\"app cf7-patient third\">\n\t\t\t<p><label> New Patient? * <span class=\"wpcf7-form-control-wrap\" data-name=\"new-patient\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"new-patient\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"Yes\">Yes<\/option><option value=\"No\">No<\/option><\/select><\/span><\/label>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t<div class=\"app cf7-first-name third\">\n\t\t\t<p><label> First Name: * <span class=\"wpcf7-form-control-wrap\" data-name=\"first-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"First Name *\" value=\"\" type=\"text\" name=\"first-name\" \/><\/span><\/label>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t<div class=\"app cf7-last-name third\">\n\t\t\t<p><label> Last Name: * <span class=\"wpcf7-form-control-wrap\" data-name=\"last-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Last Name *\" value=\"\" type=\"text\" name=\"last-name\" \/><\/span><\/label>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"section2\">\n\t\t<div class=\"app cf7-phone half left\">\n\t\t\t<p><label> Phone: * <span class=\"wpcf7-form-control-wrap\" data-name=\"your-phone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Phone *\" value=\"\" type=\"tel\" name=\"your-phone\" \/><\/span><\/label>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t<div class=\"app cf7-email half right\">\n\t\t\t<p><label> Email: * <span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Email *\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span> <\/label>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"section3\">\n\t\t<div class=\"app cf7-phone cf7-phone third\">\n\t\t\t<p><label> Preferred Physician: <span class=\"wpcf7-form-control-wrap\" data-name=\"preferred-physician\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"preferred-physician\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"Jaime A. Mercado, MD\">Jaime A. Mercado, MD<\/option><option value=\"Maria Suescum-Diaz, MD\">Maria Suescum-Diaz, MD<\/option><\/select><\/span><\/label>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t<div class=\"app cf7-phone cf7-phone third\">\n\t\t\t<p><label> Preferred Time: <span class=\"wpcf7-form-control-wrap\" data-name=\"preferred-date\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"preferred-date\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"ASAP\">ASAP<\/option><option value=\"AM\">AM<\/option><option value=\"PM\">PM<\/option><\/select><\/span><\/label>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t<div class=\"app cf7-phone cf7-phone third\">\n\t\t\t<p><label> Date Selection: <span class=\"wpcf7-form-control-wrap\" data-name=\"select-date\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" min=\"2026-07-30\" aria-invalid=\"false\" placeholder=\"Select Date\" value=\"\" type=\"date\" name=\"select-date\" \/><\/span><\/label>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"section4\">\n\t\t<div class=\"app cf7-phone third\">\n\t\t\t<p><label> Insurance: * <span class=\"wpcf7-form-control-wrap\" data-name=\"insurance\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Insurance\" value=\"\" type=\"text\" name=\"insurance\" \/><\/span><\/label>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t<div class=\"app cf7-phone third\">\n\t\t\t<p><label> Gender: <span class=\"wpcf7-form-control-wrap\" data-name=\"gender\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"gender\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"M\">M<\/option><option value=\"F\">F<\/option><option value=\"Prefer not to share\">Prefer not to share<\/option><\/select><\/span><\/label>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t<div class=\"app cf7-phone third\">\n\t\t\t<p><label> Date of Birth * <span class=\"wpcf7-form-control-wrap\" data-name=\"birth-date\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" max=\"2026-07-30\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Select Date\" value=\"\" type=\"date\" name=\"birth-date\" \/><\/span><\/label>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"app cf7-comment\">\n\t\t<p><label> Comments: * <span class=\"wpcf7-form-control-wrap\" data-name=\"comment\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Describe the reason for your appointment\" name=\"comment\"><\/textarea><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n\t<div style=\"margin-top: 15px!important\">\n\t<\/div>\n\t<p><span style=\"margin-top:15px, margin-bottom:15px\">\n\t\t<\/span><br \/>\n<input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Send\" \/>\n\t<\/p>\n<\/div><p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"_wpcf7_ak_\"><label>&#916;<textarea name=\"_wpcf7_ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"_wpcf7_ak_js\" value=\"210\"\/><script>\ndocument.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );\n<\/script>\n<\/p><input type='hidden' class='wpcf7-pum' value='{\"closepopup\":false,\"closedelay\":0,\"openpopup\":false,\"openpopup_id\":0}' \/><div class=\"fusion-alert alert custom alert-custom fusion-alert-center wpcf7-response-output fusion-alert-capitalize awb-alert-native-link-color alert-dismissable awb-alert-close-boxed\" style=\"--awb-border-size:1px;--awb-border-top-left-radius:0px;--awb-border-top-right-radius:0px;--awb-border-bottom-left-radius:0px;--awb-border-bottom-right-radius:0px;\" role=\"alert\"><div class=\"fusion-alert-content-wrapper\"><span class=\"fusion-alert-content\"><\/span><\/div><button type=\"button\" class=\"close toggle-alert\" data-dismiss=\"alert\" aria-label=\"Close\">&times;<\/button><\/div>\n<\/form>\n<\/div>\n<div class=\"fusion-text fusion-text-2\"><p style=\"text-align: center; margin-top: 20px;\">To make an appointment during office hours you could contact us at (954) 370-7036.<\/p>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-3 has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:5%;--awb-padding-bottom:5%;--awb-background-color:#f3f9ff;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-4 fusion_builder_column_1_3 1_3 fusion-one-third fusion-column-first fusion-animated\" style=\"--awb-bg-size:cover;--awb-margin-top:20px;--awb-margin-bottom:40px;width:33.3333333333%;width:calc(33.3333333333% - ( ( 4% ) * 0.333333333333 ) );margin-right: 4%;\" data-animationType=\"slideInLeft\" data-animationDuration=\"0.6\" data-animationOffset=\"top-into-view\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-title title fusion-title-2 fusion-sep-none fusion-title-text fusion-title-size-two\" style=\"--awb-margin-bottom:30px;--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;\"><h2 class=\"fusion-title-heading title-heading-left fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:45;line-height:1.11;\">Our Office<\/h2><\/div><div class=\"fusion-text fusion-text-3\"><div class=\"fusion-text\">\n<p>Address: <a href=\"https:\/\/goo.gl\/maps\/Mz23JSTWdsDwBqSE9\" target=\"_blank\" rel=\"noopener\">260 SW 84th Ave Suite D,<br \/>\nPlantation, FL 33324, USA<\/a><br \/>\nPhone: <a href=\"tel:+19543707036\">(954) 370-7036<\/a><br \/>\nFax: <a href=\"fax:+19543707037\">(954) 370-7037<\/a><\/p>\n<\/div>\n<\/div><div class=\"fusion-title title fusion-title-3 fusion-sep-none fusion-title-text fusion-title-size-two\" style=\"--awb-margin-top:30px;--awb-margin-bottom:30px;--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;\"><h2 class=\"fusion-title-heading title-heading-left fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:45;line-height:1.11;\">Office Hours<\/h2><\/div><div class=\"fusion-text fusion-text-4\"><div class=\"fusion-text\">\n<p>Monday: 08:30AM \u2013 05:00PM<br \/>\nTuesday: 08:30AM \u2013 05:00PM<br \/>\nWednesday: 08:30AM \u2013 05:00PM<br \/>\nThursday: 08:30AM \u2013 05:00PM<br \/>\nFriday: 08:30AM \u2013 01:00PM<\/p>\n<\/div>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-5 fusion_builder_column_2_3 2_3 fusion-two-third fusion-column-last fusion-animated\" style=\"--awb-bg-size:cover;--awb-margin-top:20px;--awb-margin-bottom:10px;width:66.6666666667%;width:calc(66.6666666667% - ( ( 4% ) * 0.666666666667 ) );\" data-animationType=\"fadeInUp\" data-animationDuration=\"0.6\" data-animationOffset=\"top-into-view\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><iframe src=\"https:\/\/www.google.com\/maps\/embed?pb=!1m18!1m12!1m3!1d1266.5824477386157!2d-80.2605626581056!3d26.117318523518115!2m3!1f0!2f0!3f0!3m2!1i1024!2i768!4f13.1!3m3!1m2!1s0x88d907c3e0a3c62f%3A0x7eadadae02090799!2sJaime%20A.%20Mercado%2C%20MD%2C%20FACOG%2C%20ABOG!5e0!3m2!1sen!2srs!4v1655210988878!5m2!1sen!2srs\" width=\"100%\" height=\"450\" style=\"border:0;\" allowfullscreen=\"\" loading=\"lazy\" referrerpolicy=\"no-referrer-when-downgrade\"><\/iframe><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-4 hundred-percent-fullwidth non-hundred-percent-height-scrolling fusion-equal-height-columns wh2footerlogos\" style=\"--awb-border-sizes-top:0px;--awb-border-sizes-bottom:0px;--awb-border-sizes-left:0px;--awb-border-sizes-right:0px;--awb-border-color:#5F81C6;--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:0px;--awb-padding-right:0px;--awb-padding-left:0px;--awb-background-color:#f0f3f6;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-6 fusion_builder_column_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last fusion-column-no-min-height\" style=\"--awb-padding-top:0px;--awb-padding-right:0px;--awb-padding-left:0px;--awb-bg-blend:overlay;--awb-bg-size:cover;--awb-border-color:#5F81C6;--awb-border-bottom:15px;--awb-border-style:solid;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-7 fusion_builder_column_1_2 1_2 fusion-one-half fusion-column-first wh2footerlogo\" style=\"--awb-padding-top:40px;--awb-padding-left:12%;--awb-bg-blend:overlay;--awb-bg-size:cover;width:50%;width:calc(50% - ( ( 4% ) * 0.5 ) );margin-right: 4%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-column-content-centered\"><div class=\"fusion-column-content\"><div class=\"fusion-image-element in-legacy-container\" style=\"--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><span class=\" fusion-imageframe imageframe-none imageframe-1 hover-type-none\"><a class=\"fusion-no-lightbox\" href=\"\/jaime-a-mercado-md\/\" target=\"_self\" aria-label=\"Broward-OBGYN\"><img decoding=\"async\" width=\"270\" height=\"100\" src=\"https:\/\/www.toplinemd.com\/wp-content\/uploads\/sites\/91\/2020\/06\/Broward-OBGYN.png\" alt class=\"img-responsive wp-image-971\" srcset=\"https:\/\/www.toplinemd.com\/broward-complete-obgyn-wellness-center\/wp-content\/uploads\/sites\/91\/2020\/06\/Broward-OBGYN-200x74.png 200w, https:\/\/www.toplinemd.com\/broward-complete-obgyn-wellness-center\/wp-content\/uploads\/sites\/91\/2020\/06\/Broward-OBGYN.png 270w\" sizes=\"(max-width: 1000px) 100vw, 270px\" \/><\/a><\/span><\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-8 fusion_builder_column_1_2 1_2 fusion-one-half fusion-column-last wh2footerlogo\" style=\"--awb-padding-top:40px;--awb-padding-right:4%;--awb-bg-blend:overlay;--awb-bg-size:cover;width:50%;width:calc(50% - ( ( 4% ) * 0.5 ) );\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-column-content-centered\"><div class=\"fusion-column-content\"><div class=\"fusion-image-element in-legacy-container\" 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