Provider Demographics
NPI:1477692986
Name:SAHLGREN, ERICA LYNN (PA)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:LYNN
Last Name:SAHLGREN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:3750 SAN JOSE PL STE 35
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-8861
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12276 SAN JOSE BLVD STE 210
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-8631
Practice Address - Country:US
Practice Address - Phone:904-717-9625
Practice Address - Fax:904-683-6499
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2023-07-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9104077363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAB272ZMedicare PIN