MEDICARE: MARIA ESTELA EDWARD

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	251E00000X	Home Health Agency
2	222Q00000X	Developmental Therapist		FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144426982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA ESTELA EDWARD

Provider Business Mailing Address
First Line	:	1760 KELSO AVE
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33460-6036
Country	:	US
Telephone Number	:	561-577-1620
Fax Number	:	561-650-8058

Provider Business Practice Location Address
First Line	:	3501 GEORGIA AVE
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33405-1832
Country	:	US
Telephone Number	:	561-577-1620
Fax Number	:	561-650-8058

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

Provider Enumeration Date	:	06/26/2007
Last Update Date	:	05/14/2008

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Directions to “ MARIA ESTELA EDWARD ” Practice Location

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