Healthcare Provider Details

I. General information

NPI: 1154925659
Provider Name (Legal Business Name): KARICA ELDRIDGE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2020
Last Update Date: 11/24/2020
Certification Date: 11/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27553 CASHFORD CIR STE 101
WESLEY CHAPEL FL
33544-6911
US

IV. Provider business mailing address

27553 CASHFORD CIR STE 101
WESLEY CHAPEL FL
33544-6911
US

V. Phone/Fax

Practice location:
  • Phone: 813-631-9700
  • Fax:
Mailing address:
  • Phone: 813-631-9700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT36564
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: