Healthcare Provider Details

I. General information

NPI: 1457182925
Provider Name (Legal Business Name): ERICA ESCAMILLA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERICA ESCAMILLA APRN

II. Dates (important events)

Enumeration Date: 08/08/2024
Last Update Date: 08/08/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13619 SE HIGHWAY 70
ARCADIA FL
34266-7861
US

IV. Provider business mailing address

318 HONEYMOON ST NE
LAKE PLACID FL
33852-3677
US

V. Phone/Fax

Practice location:
  • Phone: 863-491-4800
  • Fax:
Mailing address:
  • Phone: 863-243-4587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11028159
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: