Provider Demographics
NPI:1790539252
Name:INFIESTA, ERIKA MARIA (PA-C)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:MARIA
Last Name:INFIESTA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13110 N CALUSA CLUB DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1703
Mailing Address - Country:US
Mailing Address - Phone:786-395-5926
Mailing Address - Fax:
Practice Address - Street 1:8700 W FLAGLER ST STE 105
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-2428
Practice Address - Country:US
Practice Address - Phone:305-380-9916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9118580363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical