Individual
ERICA LYNN IKETANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1600 SW ARCHER RD RM 10-504, GAINESVILLE, FL 32610-3003
(352) 265-0462
Mailing address
2114 SW 102ND TER, GAINESVILLE, FL 32607-3254
(321) 987-9095
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9112811
FL
Other
Enumeration date
12/13/2019
Last updated
11/09/2020
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