MEDICARE: ERIKA FARIA PA-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
1	363A00000X	Physician Assistant	0010-11675	NC
2	363A00000X	Physician Assistant	MSPA.0000016	CO
3	363A00000X	Physician Assistant	59434	CA

General Provider Information

NPI Number	:	1649844622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIKA FARIA PA-C

Provider Business Mailing Address
First Line	:	3843 RIO VISTA DR STE 2300
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80917-3380
Country	:	US
Telephone Number	:	719-365-3700
Fax Number	:

Provider Business Practice Location Address
First Line	:	3843 RIO VISTA DR STE 2300
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80917-3380
Country	:	US
Telephone Number	:	719-365-3700
Fax Number	:	719-365-3701

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

Provider Enumeration Date	:	05/14/2021
Last Update Date	:	12/13/2024

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