Provider Demographics
NPI:1073118626
Name:KARDENAS, ERICA ALFONSA ONGCO (APRN)
Entity Type:Individual
Prefix:
First Name:ERICA ALFONSA
Middle Name:ONGCO
Last Name:KARDENAS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 SW 46TH CT APT 2606
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-6292
Mailing Address - Country:US
Mailing Address - Phone:352-870-1196
Mailing Address - Fax:
Practice Address - Street 1:10489 N FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:CITRUS SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34434-3268
Practice Address - Country:US
Practice Address - Phone:352-489-2486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11008259363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily