Provider Demographics
NPI:1215965181
Name:LONG, ERIN M (MD)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:M
Last Name:LONG
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3333 CATTLEMEN RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-6056
Mailing Address - Country:US
Mailing Address - Phone:941-379-1799
Mailing Address - Fax:941-379-1899
Practice Address - Street 1:3333 CATTLEMEN RD
Practice Address - Street 2:SUITE 106
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-6056
Practice Address - Country:US
Practice Address - Phone:941-379-1799
Practice Address - Fax:941-379-1899
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2024-10-18
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Provider Licenses
StateLicense IDTaxonomies
FLME91760207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL01506ZMedicare PIN
I36465Medicare UPIN