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General NPI Number Information
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NPI Number | 1598768145
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Entity Type | Individual
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Provider Name | TANIA C EDWARDS D.O.
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Gender | Female
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 22385 FLORA PARKE XING
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City | FERNANDINA BEACH
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State | FL
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Zip | 32034-8000
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Country | US
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Telephone | 904-404-8641
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Fax | 904-227-3246
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Provider Business Mailing Address
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Address Line | 22385 FLORA PARKE XING
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City | FERNANDINA BEACH
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State | FL
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Zip | 32034-8000
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Country | US
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Telephone | 904-404-8641
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Fax | 904-227-3246
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO.917
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 053465
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS22812
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License Number State | FL
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