Healthcare Provider Details

I. General information

NPI: 1407787435
Provider Name (Legal Business Name): ERIN PAIGE HOMUTH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 ROCKHILL CT
MARCO ISLAND FL
34145-3829
US

IV. Provider business mailing address

233 ROCKHILL CT
MARCO ISLAND FL
34145-3829
US

V. Phone/Fax

Practice location:
  • Phone: 239-595-7942
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: