MEDICARE: EDNA DANIEL NP

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	363LF0000X	Family Nurse Practitioner	0105961	CO
2	363LF0000X	Family Nurse Practitioner	101.0138622TELE	VT
3	363LF0000X	Family Nurse Practitioner	A188601	IA
4	363LF0000X	Family Nurse Practitioner	APRN11044331	FL
5	363LF0000X	Family Nurse Practitioner	16475	CT
6	363LF0000X	Family Nurse Practitioner	40745	TN
7	363LF0000X	Family Nurse Practitioner	358474	NY

General Provider Information

NPI Number	:	1336658194
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDNA DANIEL NP

Provider Business Mailing Address
First Line	:	18331 PINES BLVD # 104
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33029-1421
Country	:	US
Telephone Number	:	954-890-6910
Fax Number	:

Provider Business Practice Location Address
First Line	:	18331 PINES BLVD # 104
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33029-1421
Country	:	US
Telephone Number	:	954-589-8943
Fax Number	:

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

Provider Enumeration Date	:	09/25/2017
Last Update Date	:	02/13/2026

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