MEDICARE: EMILY EDMUNDS

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	363A00000X	Physician Assistant	PA9106203	FL

General Provider Information

NPI Number	:	1659655454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY EDMUNDS

Provider Business Mailing Address
First Line	:	PO BOX 23168
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10087-0001
Country	:	US
Telephone Number	:	210-849-0670
Fax Number	:	603-952-3900

Provider Business Practice Location Address
First Line	:	701 NORTHPOINT PKWY STE 104
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-1950
Country	:	US
Telephone Number	:	941-444-0011
Fax Number	:	603-952-3900

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

Provider Enumeration Date	:	09/29/2011
Last Update Date	:	06/05/2026

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