Individual
ERIN A WILDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1325 BELCHER RD STE A, PALM HARBOR, FL 34683-6739
(727) 547-4700
(727) 394-8661
Mailing address
12416 66TH ST STE A, LARGO, FL 33773-3430
(275) 474-7007
(727) 394-8661
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1142
SC
363AM0700X
Medical Physician Assistant
Primary
9107208
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00371588
MEDICARE RAILROAD
SC
Enumeration date
10/16/2006
Last updated
03/30/2022
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