Healthcare Provider Details

I. General information

NPI: 1194570614
Provider Name (Legal Business Name): ERYKA VINCENT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2024
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2653 BRUCE B DOWNS BLVD STE. 108A #1121
WESLEY CHAPEL FL
33544-3762
US

IV. Provider business mailing address

2653 BRUCE B DOWNS BLVD STE. 108A #1121
WESLEY CHAPEL FL
33544-3762
US

V. Phone/Fax

Practice location:
  • Phone: 561-629-4239
  • Fax:
Mailing address:
  • Phone: 561-778-4733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: