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NPI Code Detail

MEDICARE: ERIN MARY DRAKE MSN AGNP-C

MEDICARE: ERIN MARY DRAKE MSN AGNP-C
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
1363LP2300XPrimary Care Nurse PractitionerAPRN11028236FL

General Provider Information

NPI Number : 1205611712
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIN MARY DRAKE MSN AGNP-C
Provider Business Mailing Address
First Line : 200 S PARK RD STE 200
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33021-8541
Country : US
Telephone Number : 866-986-2263
Fax Number : 866-968-6339
Provider Business Practice Location Address
First Line : 200 S PARK RD STE 200
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33021-8541
Country : US
Telephone Number : 866-986-2263
Fax Number : 866-968-6339
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2023
Last Update Date : 12/17/2025

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