MEDICARE: EDWINA ESTERLIN LPN

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	164W00000X	Licensed Practical Nurse	5209152	FL

General Provider Information

NPI Number	:	1295270460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDWINA ESTERLIN LPN

Provider Business Mailing Address
First Line	:	6902 S PLYMOUTH DR
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33462-3862
Country	:	US
Telephone Number	:	561-856-0852
Fax Number	:

Provider Business Practice Location Address
First Line	:	6902 S PLYMOUTH DR
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33462-3862
Country	:	US
Telephone Number	:	561-856-0852
Fax Number	:

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

Provider Enumeration Date	:	12/27/2016
Last Update Date	:	12/27/2016

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