Healthcare Provider Details

I. General information

NPI: 1942479803
Provider Name (Legal Business Name): DR. ERIC FLORANDA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2008
Last Update Date: 08/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 WATKINS CENTRE PKWY SUITE 250
MIDLOTHIAN VA
23114-0002
US

IV. Provider business mailing address

601 WATKINS CENTRE PKWY SUITE 250
MIDLOTHIAN VA
23114-0002
US

V. Phone/Fax

Practice location:
  • Phone: 804-325-8750
  • Fax: 804-794-3172
Mailing address:
  • Phone: 804-325-8750
  • Fax: 804-794-3172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License NumberD0066693
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberD0066693
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License Number0101260345
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: