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General NPI Number Information
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NPI Number | 1407418650
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Entity Type | Individual
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Provider Name | ERICA CAMPBELL DO
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Gender | Female
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Dates
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Enumeration Date | 07/08/2019
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Last Update Date | 07/08/2019
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Provider Practice Location Address
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Address Line | 2020 26TH AVE E
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City | BRADENTON
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State | FL
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Zip | 34208-7753
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Country | US
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Telephone | 941-782-4600
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Fax | 941-782-4601
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Provider Business Mailing Address
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Address Line | 391 6TH AVE W
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City | BRADENTON
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State | FL
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Zip | 34205-8820
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Country | US
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Telephone | 941-782-4299
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Fax | 941-782-4301
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | UO6583
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License Number State | FL
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