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General NPI Number Information
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NPI Number | 1780422287
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Entity Type | Individual
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Provider Name | ERIKA LYNN HORBACK
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Gender | Female
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Dates
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Enumeration Date | 07/18/2024
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Last Update Date | 07/18/2024
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Provider Practice Location Address
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Address Line | 5 TAMPA GENERAL CIR STE 300
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City | TAMPA
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State | FL
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Zip | 33606-3578
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Country | US
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Telephone | 813-251-0793
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Fax |
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Provider Business Mailing Address
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Address Line | 8817 SW 113TH PLACE CIR W
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City | MIAMI
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State | FL
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Zip | 33176-1106
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Country | US
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Telephone | 305-323-4413
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 9118988
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License Number State | FL
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