Individual
ERICA GALLUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
14550 OLD SAINT AUGUSTINE RD, JACKSONVILLE, FL 32258-2460
(904) 271-6060
Mailing address
13803 WHITE HERON PL, JACKSONVILLE, FL 32224-4804
(904) 254-6112
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9115514
FL
Other
Enumeration date
02/10/2022
Last updated
02/10/2022
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