MEDICARE: TAMARA A EDELSTEIN-SNIDER APRN

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11000057	FL
2	363LF0000X	Family Nurse Practitioner	APRN11000057	FL

General Provider Information

NPI Number	:	1194293720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMARA A EDELSTEIN-SNIDER APRN

Provider Business Mailing Address
First Line	:	7960 N WICKHAM RD STE 101
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32940-8096
Country	:	US
Telephone Number	:	321-364-2822
Fax Number	:	877-684-0805

Provider Business Practice Location Address
First Line	:	7960 N WICKHAM RD STE 101
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32940-8096
Country	:	US
Telephone Number	:	321-364-2822
Fax Number	:	321-364-2844

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

Provider Enumeration Date	:	11/13/2018
Last Update Date	:	11/18/2025

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