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NPI Code Detail

MEDICARE: MRS. LAUREN E EDWARDS PT

MEDICARE: MRS. LAUREN E EDWARDS PT
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
1225100000XPhysical Therapist10793AZ
2225100000XPhysical TherapistPT30494FL

General Provider Information

NPI Number : 1992195044
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAUREN E EDWARDS PT
Provider Business Mailing Address
First Line : 13719 DALLAS DR
Second Line :
City : HUDSON
State : FL
Zip : 34667-7133
Country : US
Telephone Number : 727-862-6795
Fax Number :
Provider Business Practice Location Address
First Line : 13719 DALLAS DR
Second Line :
City : HUDSON
State : FL
Zip : 34667-7133
Country : US
Telephone Number : 727-862-6795
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2015
Last Update Date : 08/17/2021

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