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General NPI Number Information
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NPI Number | 1073721452
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Entity Type | Individual
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Provider Name | ERICKA DEVORE AU.D.
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Gender | Female
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 09/24/2018
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Provider Practice Location Address
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Address Line | 1250 W HWY 434 STE 1012
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City | LONGWOOD
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State | FL
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Zip | 32750-4969
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Country | US
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Telephone | 407-260-1818
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Fax | 407-260-5662
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Provider Business Mailing Address
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Address Line | 1318 E 2ND AVE
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City | MOUNT DORA
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State | FL
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Zip | 32757-5814
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Country | US
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Telephone | 774-269-0469
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AY 1457
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License Number State | FL
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