Provider Demographics
NPI:1093202061
Name:NP MEDICAL INNOVATIONS
Entity type:Organization
Organization Name:NP MEDICAL INNOVATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:813-416-8934
Mailing Address - Street 1:11229 WEMBLEY LANDING DR
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-4948
Mailing Address - Country:US
Mailing Address - Phone:813-416-8934
Mailing Address - Fax:
Practice Address - Street 1:11229 WEMBLEY LANDING DR
Practice Address - Street 2:
Practice Address - City:LITHIA
Practice Address - State:FL
Practice Address - Zip Code:33547-4948
Practice Address - Country:US
Practice Address - Phone:813-416-8934
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-16
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9197542207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty