Provider Demographics
NPI:1013146554
Name:MCCREA, ERIN (DPT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:MCCREA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3334 CAPITAL MEDICAL BLVD.
Mailing Address - Street 2:SUITE 300
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308
Mailing Address - Country:US
Mailing Address - Phone:850-877-8855
Mailing Address - Fax:850-877-7627
Practice Address - Street 1:3334 CAPITAL MEDICAL BLVD.
Practice Address - Street 2:SUITE 300
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308
Practice Address - Country:US
Practice Address - Phone:850-877-8855
Practice Address - Fax:850-877-7627
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT24751225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1376593053OtherFACILITY NPI
FL106822Medicare PIN