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General NPI Number Information
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NPI Number | 1598671414
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Entity Type | Individual
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Provider Name | ERICKSON GALLARDO PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 08/20/2026
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Last Update Date | 08/20/2026
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Provider Practice Location Address
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Address Line | 1 SHIRCLIFF WAY
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City | JACKSONVILLE
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State | FL
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Zip | 32204-4748
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Country | US
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Telephone | 904-308-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 10000 GATE PKWY N APT 1514
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City | JACKSONVILLE
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State | FL
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Zip | 32246-8215
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 310201
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT40530
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License Number State | FL
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