Provider Demographics
NPI:1366629297
Name:LUCERI, ERIKA L (PA-C)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:L
Last Name:LUCERI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2921 NE 53RD CT
Mailing Address - Street 2:
Mailing Address - City:LIGHTHOUSE POINT
Mailing Address - State:FL
Mailing Address - Zip Code:33064-7859
Mailing Address - Country:US
Mailing Address - Phone:954-298-4491
Mailing Address - Fax:
Practice Address - Street 1:7050 W PALMETTO PARK RD
Practice Address - Street 2:SUITE 30
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3426
Practice Address - Country:US
Practice Address - Phone:561-353-3376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-22
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9104375363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPA9104375OtherSTATE LICENSE