MEDICARE: DR. BRIAN SCOTT 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	111N00000X	Chiropractor	CH8204	FL

General Provider Information

NPI Number	:	1306917315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN SCOTT EDWARDS

Provider Business Mailing Address
First Line	:	9825 W SAMPLE RD STE 101
Second Line	:	# 109
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-4040
Country	:	US
Telephone Number	:	954-915-7399
Fax Number	:	954-944-0355

Provider Business Practice Location Address
First Line	:	9825 W SAMPLE RD STE 101
Second Line	:	# 109
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-4040
Country	:	US
Telephone Number	:	954-915-7399
Fax Number	:	954-944-0355

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

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	09/08/2016

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