Individual
ERIC INNOCENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9096 SW 36TH MNR, MIRAMAR, FL 33025-7964
(786) 320-3048
Mailing address
9096 SW 36TH MNR, MIRAMAR, FL 33025-7964
(786) 320-3048
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10296
AZ
363A00000X
Physician Assistant
1365-P.A.
PR
Other
Enumeration date
08/22/2022
Last updated
03/31/2024
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