Provider Demographics
NPI:1891770269
Name:ERIKSEN, DEBRA (DO)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:ERIKSEN
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7033 RIVERGATE AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-0917
Mailing Address - Country:US
Mailing Address - Phone:813-334-2322
Mailing Address - Fax:
Practice Address - Street 1:7033 RIVERGATE AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33637-0917
Practice Address - Country:US
Practice Address - Phone:813-333-6278
Practice Address - Fax:813-333-6279
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS5597207L00000X
IN02008142A207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL80149OtherBCBS
FL375252600Medicaid
FL80149Medicare ID - Type Unspecified
FL375252600Medicaid