Provider Demographics
NPI:1942479803
Name:FLORANDA, ERIC
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:FLORANDA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 WATKINS CENTRE PKWY
Mailing Address - Street 2:SUITE 250
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-0002
Mailing Address - Country:US
Mailing Address - Phone:804-325-8750
Mailing Address - Fax:804-794-3172
Practice Address - Street 1:601 WATKINS CENTRE PKWY
Practice Address - Street 2:SUITE 250
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-0002
Practice Address - Country:US
Practice Address - Phone:804-325-8750
Practice Address - Fax:804-794-3172
Is Sole Proprietor?:No
Enumeration Date:2008-02-25
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00666932084N0008X, 2084N0400X
VA01012603452084N0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC09633OtherGROUP PTAN