Healthcare Provider Details

I. General information

NPI: 1659655454
Provider Name (Legal Business Name): EMILY EDMUNDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY MORRIS

II. Dates (important events)

Enumeration Date: 09/29/2011
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 NORTHPOINT PKWY STE 104
WEST PALM BEACH FL
33407-1950
US

IV. Provider business mailing address

PO BOX 23168
NEW YORK NY
10087-0001
US

V. Phone/Fax

Practice location:
  • Phone: 941-444-0011
  • Fax: 603-952-3900
Mailing address:
  • Phone: 210-849-0670
  • Fax: 603-952-3900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9106203
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: