Provider Demographics
NPI:1760051841
Name:SACERIO, ERIKA (PTA)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:SACERIO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2717 EAGLE CANYON DR S
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-3170
Mailing Address - Country:US
Mailing Address - Phone:407-914-9168
Mailing Address - Fax:407-337-8005
Practice Address - Street 1:395 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-4012
Practice Address - Country:US
Practice Address - Phone:407-914-9168
Practice Address - Fax:407-337-8005
Is Sole Proprietor?:No
Enumeration Date:2021-06-22
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA30686225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL112243500Medicaid