Healthcare Provider Details

I. General information

NPI: 1528904976
Provider Name (Legal Business Name): IMPERATIVE.2 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4850 51ST ST W APT 4104
BRADENTON FL
34210-6612
US

IV. Provider business mailing address

4850 51ST ST W APT 4104
BRADENTON FL
34210-6612
US

V. Phone/Fax

Practice location:
  • Phone: 941-757-6320
  • Fax:
Mailing address:
  • Phone: 941-757-6320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MARVIN JERMAINE EDWARDS SR.
Title or Position: OWNER
Credential: CNA
Phone: 941-757-6320