Provider Demographics
NPI:1760752729
Name:MIRON, ERIKA (PHARM D)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:MIRON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 ROANOKE SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:RUSKIN
Mailing Address - State:FL
Mailing Address - Zip Code:33570-6312
Mailing Address - Country:US
Mailing Address - Phone:850-443-5534
Mailing Address - Fax:
Practice Address - Street 1:12028 MAJESTIC BLVD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-2418
Practice Address - Country:US
Practice Address - Phone:727-863-4575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS47568183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist