Healthcare Provider Details

I. General information

NPI: 1285025379
Provider Name (Legal Business Name): ERICA SANES A.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2015
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 CEDARSTONE WAY
SAINT AUGUSTINE FL
32092-0010
US

IV. Provider business mailing address

140 MONTCLAIRE DR
WESTON FL
33326-3587
US

V. Phone/Fax

Practice location:
  • Phone: 754-227-9016
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP 3565
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH21226
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: