Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | APRN9375250 | FL |
N | 363LF0000X | Nurse Practitioner - Family Medicine | ARNP9375250 | FL |
NPI | 1003269168 |
---|---|
Provider Name | Edward Erickson |
First Address | Miami, FL 33133-4219 |
Second Address | Miami, FL 33133-4219 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2016 |
Last Update Date | 27/01/2022 |