Healthcare Provider Details

I. General information

NPI: 1598545592
Provider Name (Legal Business Name): ERICA KRIDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2023
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7320 GRIFFIN RD STE 214
DAVIE FL
33314-4105
US

IV. Provider business mailing address

7320 GRIFFIN RD STE 214
DAVIE FL
33314-4105
US

V. Phone/Fax

Practice location:
  • Phone: 954-480-3665
  • Fax:
Mailing address:
  • Phone: 954-604-6070
  • Fax: 954-569-3773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH26751
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: