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NPI Code Detail

MEDICARE: BENNITTA DENISE EDMEADE APRN

MEDICARE: BENNITTA DENISE EDMEADE APRN
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
1363LF0000XFamily Nurse PractitionerARNP9283268FL
2363LF0000XFamily Nurse PractitionerAPRN9283268FL
3363LP2300XPrimary Care Nurse PractitionerARNP9283268FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770956971
Entity Type Code : Individual
Provider Name (Legal Business Name) : BENNITTA DENISE EDMEADE APRN
Provider Business Mailing Address
First Line : 8051 N TAMIAMI TRL STE E6
Second Line :
City : SARASOTA
State : FL
Zip : 34243-2067
Country : US
Telephone Number : 407-501-8886
Fax Number :
Provider Business Practice Location Address
First Line : 8051 N TAMIAMI TRL STE E6
Second Line :
City : SARASOTA
State : FL
Zip : 34243-2067
Country : US
Telephone Number : 407-501-8886
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2015
Last Update Date : 11/03/2023

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