Provider Demographics
NPI:1215762075
Name:ARMSTEAD, ERICK
Entity type:Individual
Prefix:
First Name:ERICK
Middle Name:
Last Name:ARMSTEAD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12951 METRO PKWY STE 10
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33966-1333
Mailing Address - Country:US
Mailing Address - Phone:239-281-6685
Mailing Address - Fax:
Practice Address - Street 1:12951 METRO PKWY STE 10
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33966-1333
Practice Address - Country:US
Practice Address - Phone:239-281-6685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-03
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL133NN1002X
FLT2198473747P1801X, 171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant