Healthcare Provider Details

I. General information

NPI: 1457702755
Provider Name (Legal Business Name): ERIKA MICHELE CASCIO PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIKA MICHELE MELLOTT PSY.D.

II. Dates (important events)

Enumeration Date: 06/28/2016
Last Update Date: 08/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD SUITE G901
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

5703 SW 10TH PL
GAINESVILLE FL
32607-3864
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-5117
  • Fax:
Mailing address:
  • Phone: 330-819-8662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPY9488
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: