MEDICARE: ERICA LYLES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225A00000X	Music Therapist	09764	FL

General Provider Information

NPI Number	:	1053269639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA LYLES

Provider Business Mailing Address
First Line	:	2260 SE UNION PARK DR
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34952-8031
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8442 S US HIGHWAY 1
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34952-3306
Country	:	US
Telephone Number	:	561-501-1086
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2026
Last Update Date	:	03/19/2026

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