Provider Demographics
NPI:1417754144
Name:MARTIN-EDWARDS, KAITLYN (DC)
Entity type:Individual
Prefix:DR
First Name:KAITLYN
Middle Name:
Last Name:MARTIN-EDWARDS
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 BERKMAN CIR FL 32771USA
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-6309
Mailing Address - Country:US
Mailing Address - Phone:912-409-2009
Mailing Address - Fax:
Practice Address - Street 1:351 N RONALD REAGAN BLVD STE 1015
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-4159
Practice Address - Country:US
Practice Address - Phone:407-417-2533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH15360111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor