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NPI Code Detail

MEDICARE: ERICA LEE PA-C

MEDICARE: ERICA LEE 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
1363A00000XPhysician AssistantPA9116519FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PA9116519OTHERFLPA STATE LICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780309344
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICA LEE PA-C
Provider Business Mailing Address
First Line : 9208 KING PALM DR
Second Line :
City : TAMPA
State : FL
Zip : 33619-1328
Country : US
Telephone Number : 813-828-2273
Fax Number : 813-736-4871
Provider Business Practice Location Address
First Line : 9208 KING PALM DR
Second Line :
City : TAMPA
State : FL
Zip : 33619-1328
Country : US
Telephone Number : 813-828-2273
Fax Number : 813-736-4871
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2022
Last Update Date : 12/11/2025

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Directions to “ ERICA LEE PA-C” Practice Location

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