Provider Demographics
NPI:1205526688
Name:MARS, ERIKA (PA-C)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:MARS
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 1:20011 NE 22ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1802
Mailing Address - Country:US
Mailing Address - Phone:305-904-2902
Mailing Address - Fax:
Practice Address - Street 1:2920 NE 207TH ST STE 802
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1441
Practice Address - Country:US
Practice Address - Phone:305-466-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9117405363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant