Provider Demographics
NPI:1811421357
Name:MEJIA, ERICK VICTOR (DO)
Entity type:Individual
Prefix:
First Name:ERICK
Middle Name:VICTOR
Last Name:MEJIA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8601 MILESTONE DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34238-3902
Mailing Address - Country:US
Mailing Address - Phone:512-586-6516
Mailing Address - Fax:
Practice Address - Street 1:1990 MAIN ST STE 750
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-8000
Practice Address - Country:US
Practice Address - Phone:512-586-6516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-11
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS16625207QB0002X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity Medicine