Provider Demographics
NPI:1093925547
Name:LEROUX, ERIKA X (RPH)
Entity Type:Individual
Prefix:MISS
First Name:ERIKA
Middle Name:X
Last Name:LEROUX
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 JUNGLE AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-4308
Mailing Address - Country:US
Mailing Address - Phone:813-334-0914
Mailing Address - Fax:
Practice Address - Street 1:2460 E BAY DR
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-2404
Practice Address - Country:US
Practice Address - Phone:727-535-2636
Practice Address - Fax:727-524-3589
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS35583183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist