Healthcare Provider Details

I. General information

NPI: 1922938067
Provider Name (Legal Business Name): JASMINE EDWARDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12361 HAGEN RANCH RD STE 503-2070
BOYNTON BEACH FL
33437-4174
US

IV. Provider business mailing address

10189 LEXINGTON LAKES BLVD N
BOYNTON BEACH FL
33436-4552
US

V. Phone/Fax

Practice location:
  • Phone: 561-710-0624
  • Fax:
Mailing address:
  • Phone: 561-710-0624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: