Preventive Medicine Ctr of Gainesville Inc

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

PREVENTIVE MEDICINE CTR OF GAINESVILLE INC

Practice address

905 NW 56TH Terrace
Suite B
Gainesville, FL 32605

Phone

(352) 331-5138

Fax

(352) 331-9399

NPI assigned

Mar 14, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Robert A Erickson, MDNPI 1417196635

Title

Medical Director

Phone

(352) 331-5138

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert A. Erickson, M.D.

  • Family Medicine Physician
  • Gainesville, FL
  • NPI 1417196635
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063546133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 NW 56TH TERRACE",
            "address_2": "SUITE B",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32605",
            "telephone_number": "352-331-5138",
            "fax_number": "352-331-9399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 NW 56TH TERRACE",
            "address_2": "SUITE B",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32605",
            "telephone_number": "352-331-5138",
            "fax_number": "352-331-9399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVENTIVE MEDICINE CTR OF GAINESVILLE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "352-331-5138",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE ID",
            "identifier": "ME22324",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.