Individual
JILL HOLLY ERBELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
714 MANATEE AVE E, BRADENTON, FL 34208-1235
(941) 212-2010
(941) 212-3330
Mailing address
714 MANATEE AVE E, BRADENTON, FL 34208-1235
(941) 212-2010
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9105325
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001804300
—
FL
01
—
PA9105325
LICENSE NUMBER
FL
01
—
Y02AX
BCBS
FL
Enumeration date
01/05/2010
Last updated
03/26/2024
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