MEDICARE: EDGE FAMILY CHIROPRACTIC, P.A.

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	111N00000X	Chiropractor	CH0005258	FL

General Provider Information

NPI Number	:	1285950113
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDGE FAMILY CHIROPRACTIC, P.A.

Provider Business Mailing Address
First Line	:	8124 PENSACOLA BLVD
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32534-4354
Country	:	US
Telephone Number	:	850-476-7117
Fax Number	:	850-479-4622

Provider Business Practice Location Address
First Line	:	8124 PENSACOLA BLVD
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32534-4354
Country	:	US
Telephone Number	:	850-476-7117
Fax Number	:	850-479-4622

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. GREGORY STEWART
Credential	:
Telephone Number	:	850-476-7117

Provider Enumeration Date	:	04/16/2010
Last Update Date	:	12/17/2025

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