Healthcare Provider Details

I. General information

NPI: 1144067653
Provider Name (Legal Business Name): ERIN MOCKLER EATON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2024
Last Update Date: 06/13/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12823 SOLOLA WAY
TRINITY FL
34655-7246
US

IV. Provider business mailing address

21129 PLEASANT PLAINS PKWY
LAND O LAKES FL
34637-6403
US

V. Phone/Fax

Practice location:
  • Phone: 727-215-2773
  • Fax:
Mailing address:
  • Phone: 727-215-2773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-81727
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: