Provider Demographics
NPI:1235248782
Name:JAMES, ERIN C (PA)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:C
Last Name:JAMES
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4725 NORTH FEDERAL HWY
Mailing Address - Street 2:SUITE 401
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308
Mailing Address - Country:US
Mailing Address - Phone:954-772-2136
Mailing Address - Fax:904-772-7156
Practice Address - Street 1:4725 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4603
Practice Address - Country:US
Practice Address - Phone:954-772-2136
Practice Address - Fax:954-772-7156
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9102420363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA736120853AMedicaid
FL2925281-00Medicaid
GA736120853AMedicaid
FLQ76824Medicare UPIN
FLAB604YMedicare PIN