MEDICARE: LAURA D EDWARDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376J00000X	Homemaker	241555	FL

General Provider Information

NPI Number	:	1063354140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA D EDWARDS

Provider Business Mailing Address
First Line	:	3015 LAKEHOUSE COVE ISLE APT 303
Second Line	:	303
City	:	PLANT CITY
State	:	FL
Zip	:	33566-7440
Country	:	US
Telephone Number	:	813-734-1066
Fax Number	:

Provider Business Practice Location Address
First Line	:	3015 LAKEHOUSE COVE ISLE APT 303
Second Line	:
City	:	PLANT CITY
State	:	FL
Zip	:	33566-7440
Country	:	US
Telephone Number	:	813-734-1066
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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