Individual ProviderErica Denise PenaNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address6200 SW 73rd St, South Miami, FL 33143-4679(786) 662-4000(786) 320-1216PECOS EnrollmentBased on the most recent information from CMS, provider Erica Denise Pena does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1023244803Provider TypeIndividualFull NamePena, Erica DeniseCredentialARNPGenderFemaleSole ProprietorNoEnumeration Date6/6/2009Last Updated1/5/2023Contact InformationPractice LocationPractice Address6200 SW 73rd St, South Miami, FL 33143-4679Phone(786) 662-4000FaxUnlisted FaxMailing LocationMailing Address1475 NW 81st Ave, Coral Springs, FL 33071-6224Phone(786) 320-1216FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAPRN11015862FloridaCode163W00000XDescriptionRegistered NurseNursing Service ProvidersLicenseRN9578535FloridaCode363L00000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseRN206475GeorgiaCode363LF0000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseRN206475GeorgiaProvider IdentifiersIDDescriptionIssuerID003120412ADescriptionMedicaidIssuerUnlistedGeorgia