MEDICARE: EDGEWATER INTERNAL MEDICINE ASSOC. INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME0063341	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	23541	OTHER		BCBS

General Provider Information

NPI Number	:	1518938372
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDGEWATER INTERNAL MEDICINE ASSOC. INC.

Provider Business Mailing Address
First Line	:	2568 SOUTH RIDGEWOOD AVE
Second Line	:	SUITE 5
City	:	EDGEWATER
State	:	FL
Zip	:	32111-7535
Country	:	US
Telephone Number	:	386-428-4640
Fax Number	:	386-426-1409

Provider Business Practice Location Address
First Line	:	2568 S. RIDGEWOOD AVE
Second Line	:	SUITE 5
City	:	EDGEWATER
State	:	FL
Zip	:	32141-7535
Country	:	US
Telephone Number	:	386-428-4640
Fax Number	:	386-426-1409

Authorized Official
Title or Position	:	PRESIDENT OWNER
Name	:	DR. LESLIE MANUEL LEE
Credential	:	MD
Telephone Number	:	386-428-4640

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	08/04/2014

Similar Medicare Providers

1275643397 — JEFFREY R BERNER PT
Practice Location Address:

2568 S RIDGEWOOD AVENUE , SUITE 1
EDGEWATER, FL
32141-7535

Practice Phone: 386-423-0100
Practice Fax: 386-428-8631

1740137439 — ELENA GRANT-SCHRAMM
Practice Location Address:

975 VOLCO RD
EDGEWATER, FL
32141-7007

Practice Phone: 386-527-9838
Practice Fax:

1033119565 — NATIONWIDE MEDICAL HOSPITALITY SERVICES INC
Practice Location Address:

2018 S RIDGEWOOD AVE
EDGEWATER, FL
32141-4207

Practice Phone: 386-427-6482
Practice Fax: 386-427-6870

1538156146 — MRS. PAULA ADELLE HALL D.O.
Practice Location Address:

3048 SILVER PALM DR. , SUITE B
EDGEWATER, FL
32141

Practice Phone: 386-209-8634
Practice Fax: 321-473-3689

1831179878 — RICHARD MICHAEL HARTMAN CRNA
Practice Location Address:

2621 UMBRELLA TREE DR
EDGEWATER, FL
32141-5311

Practice Phone: 386-846-8181
Practice Fax:

1174594295 — DR. SHARON L SHELTON DO
Practice Location Address:

2984 S RIDGEWOOD AVE STE A
EDGEWATER, FL
32141-7527

Practice Phone: 386-428-4640
Practice Fax:

Directions to “EDGEWATER INTERNAL MEDICINE ASSOC. INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.