Provider Demographics
NPI:1952138174
Name:HALVELAND, ERIC SCOTT
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:SCOTT
Last Name:HALVELAND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6625 ARGYLE FOREST BLVD
Mailing Address - Street 2:#4 3059
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-6670
Mailing Address - Country:US
Mailing Address - Phone:904-762-3137
Mailing Address - Fax:
Practice Address - Street 1:6625 ARGYLE FOREST BLVD
Practice Address - Street 2:#4 3059
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-6670
Practice Address - Country:US
Practice Address - Phone:904-762-3137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle