MEDICARE: DR. HEIDI ERICKSON MD

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	208000000X	Pediatrics Physician	30665	AZ
2	2084P0800X	Psychiatry Physician	30665	AZ
3	2084P0804X	Child & Adolescent Psychiatry Physician	30665	AZ
4	208000000X	Pediatrics Physician	35.073211	OK
5	2084P0800X	Psychiatry Physician	ME115146	FL
6	2084P0804X	Child & Adolescent Psychiatry Physician	ME115146	FL
7	208000000X	Pediatrics Physician	ME115146	FL

General Provider Information

NPI Number	:	1871598508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HEIDI ERICKSON MD

Provider Business Mailing Address
First Line	:	4800 LINTON BLVD
Second Line	:	SUITE D502A
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-6584
Country	:	US
Telephone Number	:	561-808-7205
Fax Number	:	561-584-6804

Provider Business Practice Location Address
First Line	:	4800 LINTON BLVD
Second Line	:	SUITE D502A
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-6584
Country	:	US
Telephone Number	:	561-808-7205
Fax Number	:	561-584-6804

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

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	12/09/2014

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Directions to “ DR. HEIDI ERICKSON MD” Practice Location

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