Provider Demographics
NPI:1982590659
Name:BLEECKER, ERICA J (OD)
Entity type:Individual
Prefix:DR
First Name:ERICA
Middle Name:J
Last Name:BLEECKER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 290201
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33329-0201
Mailing Address - Country:US
Mailing Address - Phone:315-877-5164
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 290201
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33329-0201
Practice Address - Country:US
Practice Address - Phone:315-877-5164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC6713152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist