Provider Demographics
NPI:1124328125
Name:PODOLSKY, ERICA R (MD)
Entity type:Individual
Prefix:DR
First Name:ERICA
Middle Name:R
Last Name:PODOLSKY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1601 CLINT MOORE RD
Mailing Address - Street 2:SUITE 145
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-2768
Mailing Address - Country:US
Mailing Address - Phone:561-939-0455
Mailing Address - Fax:561-939-5460
Practice Address - Street 1:1601 CLINT MOORE RD
Practice Address - Street 2:SUITE 145
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-2768
Practice Address - Country:US
Practice Address - Phone:561-939-0455
Practice Address - Fax:561-939-5460
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2015-04-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMT189370208600000X
NC2013-00610208600000X
FLME121024208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery