Provider Demographics
NPI:1194998997
Name:CAPRILES, ERIC EDWARD (MD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:EDWARD
Last Name:CAPRILES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 MEDICAL OAKS AVE
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5961
Mailing Address - Country:US
Mailing Address - Phone:813-685-7995
Mailing Address - Fax:813-643-8777
Practice Address - Street 1:519 MEDICAL OAKS AVE
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5961
Practice Address - Country:US
Practice Address - Phone:813-685-7995
Practice Address - Fax:813-643-8777
Is Sole Proprietor?:No
Enumeration Date:2008-04-12
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ43714208600000X
FLME166363208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ43714OtherAZ LICENSE
AZ555715Medicaid
GA001623OtherPHYSICIAN, GENERAL SURGER
AZ555715Medicaid