Healthcare Provider Details

I. General information

NPI: 1174194047
Provider Name (Legal Business Name): ERIC ADCOX
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2021
Last Update Date: 06/19/2024
Certification Date: 06/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-5298
US

IV. Provider business mailing address

7433 SURREY WOOD LN
APOLLO BEACH FL
33572-1533
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-6438
  • Fax:
Mailing address:
  • Phone: 864-986-5666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11014055
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License NumberAPRN11014055
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: