MEDICARE: SHERELL EDWARDS DR

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	171400000X	Health & Wellness Coach
2	246RP1900X	Phlebotomy Technician	22-2016	FL
3	174H00000X	Health Educator

General Provider Information

NPI Number	:	1649426008
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERELL EDWARDS DR

Provider Business Mailing Address
First Line	:	6501 ARLINGTON EXPY STE B1052208
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32211-5779
Country	:	US
Telephone Number	:	321-710-6568
Fax Number	:

Provider Business Practice Location Address
First Line	:	6501 ARLINGTON EXPY STE B1052208
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32211-5779
Country	:	US
Telephone Number	:	321-710-6568
Fax Number	:

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

Provider Enumeration Date	:	08/15/2008
Last Update Date	:	08/10/2024

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Directions to “ SHERELL EDWARDS DR” Practice Location

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