Basic Information
Provider Information
NPI: 1750649448
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ERDMAN
FirstName: FELICIA
MiddleName: M.
NamePrefix:  
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5955 PONCE DE LEON BLVD.
Address2:  
City: CORAL GABLES
State: FL
PostalCode: 331462423
CountryCode: US
TelephoneNumber: 3056611515
FaxNumber: 3056623723
Practice Location
Address1: 5955 PONCE DE LEON BLVD
Address2:  
City: CORAL GABLES
State: FL
PostalCode: 331462423
CountryCode: US
TelephoneNumber: 3056611515
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/01/2012
LastUpdateDate: 08/21/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LN0000X9295871FLN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
363LN0000XARNP9295871FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal

No ID Information.


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