Provider Demographics
NPI:1225580178
Name:O'NEILL, ERIN (DPM, PA-C)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:DPM, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 HILLCREST ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-1211
Mailing Address - Country:US
Mailing Address - Phone:407-425-1566
Mailing Address - Fax:
Practice Address - Street 1:217 HILLCREST ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-1211
Practice Address - Country:US
Practice Address - Phone:843-422-3308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-26
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO4043213EP1101X, 213ES0103X
VA0116029554213ES0103X
FLPA9113338363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery