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General NPI Number Information
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NPI Number | 1154998292
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Entity Type | Individual
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Provider Name | JEREMY DUANE EADES ARNP
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Gender | Male
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Dates
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Enumeration Date | 06/08/2021
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Last Update Date | 08/06/2024
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Provider Practice Location Address
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Address Line | 4302 ALTON RD STE 540
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City | MIAMI BEACH
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State | FL
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Zip | 33140-2842
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Country | US
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Telephone | 305-731-8410
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Fax |
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Provider Business Mailing Address
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Address Line | 19672 INDIAN MOUND DR
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City | SUMMERLAND KEY
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State | FL
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Zip | 33042-3141
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Country | US
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Telephone | 305-731-8410
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11013555
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License Number State | FL
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