MEDICARE: DR. DARREN JAMES EDMONDS D.C.

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	CH8091	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	70249	OTHER	FL	BLUE CROSS PROVIDER #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902917016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DARREN JAMES EDMONDS D.C.

Provider Business Mailing Address
First Line	:	PO BOX 21962
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34276-4962
Country	:	US
Telephone Number	:	941-365-8555
Fax Number	:	941-758-3577

Provider Business Practice Location Address
First Line	:	3139 SOUTHGATE CIR
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34239-5515
Country	:	US
Telephone Number	:	941-365-8555
Fax Number	:	941-758-3577

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	02/16/2011

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