Provider Demographics
NPI:1427502905
Name:EDWARDS, DARIAN (MS)
Entity type:Individual
Prefix:
First Name:DARIAN
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11509 SOLAYA WAY UNIT 101
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32821-9447
Mailing Address - Country:US
Mailing Address - Phone:407-395-9976
Mailing Address - Fax:
Practice Address - Street 1:11509 SOLAYA WAY UNIT 101
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32821-9447
Practice Address - Country:US
Practice Address - Phone:407-395-9976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-12
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018625000Medicaid