Provider Demographics
NPI:1477868677
Name:BODENHEIMER, ERIN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:
Last Name:BODENHEIMER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 N ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-5516
Mailing Address - Country:US
Mailing Address - Phone:407-897-5292
Mailing Address - Fax:407-897-6635
Practice Address - Street 1:2100 N ORANGE AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-5516
Practice Address - Country:US
Practice Address - Phone:407-897-5292
Practice Address - Fax:407-897-6635
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2022-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY061601183500000X
AZS017974183500000X
FLPS56172183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist