Healthcare Provider Details

I. General information

NPI: 1942581475
Provider Name (Legal Business Name): ERIN C ALBERT RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN C BURY RD

II. Dates (important events)

Enumeration Date: 08/29/2011
Last Update Date: 12/07/2022
Certification Date: 12/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 TAMPA GENERAL CIR
TAMPA FL
33606-3571
US

IV. Provider business mailing address

PO BOX 1289
TAMPA FL
33601-1289
US

V. Phone/Fax

Practice location:
  • Phone: 813-844-7473
  • Fax: 813-844-1966
Mailing address:
  • Phone: 813-844-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberND10178
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: