Provider Demographics
NPI:1154998292
Name:EADES, JEREMY DUANE (ARNP)
Entity type:Individual
Prefix:MR
First Name:JEREMY
Middle Name:DUANE
Last Name:EADES
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19672 INDIAN MOUND DR
Mailing Address - Street 2:
Mailing Address - City:SUMMERLAND KEY
Mailing Address - State:FL
Mailing Address - Zip Code:33042-3141
Mailing Address - Country:US
Mailing Address - Phone:305-731-8410
Mailing Address - Fax:
Practice Address - Street 1:4302 ALTON RD STE 540
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2842
Practice Address - Country:US
Practice Address - Phone:305-731-8410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11013555363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily