Provider Demographics
NPI:1023336898
Name:ALDRIDGE, ERICA JANE (DO)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:JANE
Last Name:ALDRIDGE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:JANE
Other - Last Name:PEART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 17567
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32522-7567
Mailing Address - Country:US
Mailing Address - Phone:850-437-8640
Mailing Address - Fax:850-437-8649
Practice Address - Street 1:1717 N E ST STE 425
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-6333
Practice Address - Country:US
Practice Address - Phone:850-437-8640
Practice Address - Fax:850-437-8649
Is Sole Proprietor?:No
Enumeration Date:2010-05-04
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT013429207R00000X
FLOS13337207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL150JSOtherBLUE CROSS BLUE SHIELD OF FLORIDA
FL015147400Medicaid