Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | OT013429 | PA |
N | 111NI0900X | Internist | OT013429 | PA |
Y | 207RR0500X | Rheumatology | OS13337 | FL |
NPI | 1023336898 |
---|---|
Provider Name | Erica Jane Aldridge |
First Address | Pensacola, FL 32522-7567 |
Second Address | Pensacola, FL 32501-6333 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2010 |
Last Update Date | 19/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
015147400 | (05) | FL |
150JS | BLUE CROSS BLUE SHIELD OF FLORIDA (01) | FL |