Healthcare Provider Details

I. General information

NPI: 1003738857
Provider Name (Legal Business Name): COREPATH PSYCHIATRY & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2295 S HIAWASSEE RD STE 104
ORLANDO FL
32835-8748
US

IV. Provider business mailing address

7901 4TH ST N STE 300
ST PETERSBURG FL
33702-4399
US

V. Phone/Fax

Practice location:
  • Phone: 407-247-5566
  • Fax:
Mailing address:
  • Phone: 321-780-0920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ERIKA ARCHICA NOTICE
Title or Position: OWNER
Credential: PMHNP
Phone: 321-780-0920