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General NPI Number Information
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NPI Number | 1093202061
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Entity Type | Organization
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Legal Business Name | NP MEDICAL INNOVATIONS
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Dates
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Enumeration Date | 04/16/2018
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Last Update Date | 04/16/2018
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Provider Practice Location Address
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Address Line | 11229 WEMBLEY LANDING DR
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City | LITHIA
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State | FL
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Zip | 33547-4948
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Country | US
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Telephone | 813-416-8934
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Fax |
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Provider Business Mailing Address
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Address Line | 11229 WEMBLEY LANDING DR
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City | LITHIA
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State | FL
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Zip | 33547-4948
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Country | US
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Telephone | 813-416-8934
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTINE ANN EDWARDS
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Credential | NP
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Telephone | 813-416-8934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ARNP9197542
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License Number State | FL
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