Provider Demographics
NPI:1659616522
Name:LOBATO, ERICA (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:
Last Name:LOBATO
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 LAKE CHARLES DR
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-3607
Mailing Address - Country:US
Mailing Address - Phone:305-322-5907
Mailing Address - Fax:
Practice Address - Street 1:900 ORCHID SPRINGS DR STE 102
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33884-3655
Practice Address - Country:US
Practice Address - Phone:863-250-1096
Practice Address - Fax:863-250-4749
Is Sole Proprietor?:No
Enumeration Date:2012-12-04
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9299439363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily