Healthcare Provider Details

I. General information

NPI: 1629402128
Provider Name (Legal Business Name): ERIN CHRISTINE SYPOLT PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2013
Last Update Date: 09/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1606 DEL PRADO BLVD S
CAPE CORAL FL
33990-3798
US

IV. Provider business mailing address

15360 SONOMA DR APT 304
FORT MYERS FL
33908-7305
US

V. Phone/Fax

Practice location:
  • Phone: 239-458-7427
  • Fax:
Mailing address:
  • Phone: 724-977-3025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS51096
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: