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NPI Code Detail

MEDICARE: DR. JESSICA EDGAR PHARMD

MEDICARE: DR. JESSICA EDGAR PHARMD
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
1183500000XPharmacistPS64386FL

General Provider Information

NPI Number : 1992490163
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JESSICA EDGAR PHARMD
Provider Business Mailing Address
First Line : 10075 S JOG RD STE 101
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33437-3532
Country : US
Telephone Number : 561-408-0796
Fax Number : 561-652-8653
Provider Business Practice Location Address
First Line : 100 JOHN F KENNEDY DR
Second Line :
City : ATLANTIS
State : FL
Zip : 33462-1120
Country : US
Telephone Number : 561-232-2893
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2023
Last Update Date : 02/24/2026

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