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General NPI Number Information
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NPI Number | 1407083520
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Entity Type | Individual
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Provider Name | ERICA ACOSTA BARTELT MD
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Gender | Female
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Dates
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Enumeration Date | 06/16/2009
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Last Update Date | 02/19/2016
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Provider Practice Location Address
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Address Line | 621 VICTORIA ST
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City | BRANDON
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State | FL
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Zip | 33510-4313
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Country | US
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Telephone | 813-655-0292
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Fax | 813-655-4302
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Provider Business Mailing Address
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Address Line | 621 VICTORIA ST
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City | BRANDON
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State | FL
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Zip | 33510-4313
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Country | US
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Telephone | 813-655-0292
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Fax | 813-655-4302
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME 112953
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License Number State | FL
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