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General NPI Number Information
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NPI Number | 1154722650
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Entity Type | Organization
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Legal Business Name | DEAN M EDWARDS DPT INC
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Dates
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Enumeration Date | 09/16/2014
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Last Update Date | 09/16/2014
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Provider Practice Location Address
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Address Line | 782 SILVER CLOUD CIR # 204
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City | LAKE MARY
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State | FL
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Zip | 32746-1535
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Country | US
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Telephone | 914-320-3233
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Fax |
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Provider Business Mailing Address
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Address Line | 2350 NAUTICAL WAY APT 114
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City | WINTER PARK
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State | FL
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Zip | 32792-1257
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Country | US
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Telephone | 914-320-3233
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. DEAN MARK ANTHONY EDWARDS SR.
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Credential | DPT
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Telephone | 914-320-3233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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