Provider Demographics
NPI:1235950585
Name:FILIS, ERIKA LEE
Entity type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:LEE
Last Name:FILIS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ERIKA
Other - Middle Name:LEE
Other - Last Name:JOHANSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:815 BRIAR CREEK BLVD NE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-5423
Mailing Address - Country:US
Mailing Address - Phone:321-506-2862
Mailing Address - Fax:
Practice Address - Street 1:3266 HAINLIN AVE SE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32909-8239
Practice Address - Country:US
Practice Address - Phone:321-506-2862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL24467225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant