Healthcare Provider Details

I. General information

NPI: 1245155159
Provider Name (Legal Business Name): EDWARD HENRY MADDEN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 N BELCHER RD
CLEARWATER FL
33765-2138
US

IV. Provider business mailing address

750 N BELCHER RD
CLEARWATER FL
33765-2138
US

V. Phone/Fax

Practice location:
  • Phone: 727-754-3879
  • Fax:
Mailing address:
  • Phone: 727-754-3879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH16086
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: