Individual
ERICA ELIZABETH ELSEED PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
17 DAVIS BLVD, SUITE 208, TAMPA, FL 33606-3475
(813) 259-0998
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 821-8038
(813) 974-4325
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
ME140498
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115073900
—
FL
01
—
ARFMN
BLUE CROSS BLUE SHIELD
FL
Enumeration date
04/05/2016
Last updated
08/29/2022
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