Edelenbos, Eric J.

Edelenbos, Eric J. is an individual health care provider with primary practice located at 1680 Eagle Harbor Pkwy Ste A , Orange Park FL 32003-4821. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Edelenbos, Eric J. can be contacted via phone (904) 264-9555.

Contact Information

Primary practice address
1680 Eagle Harbor Pkwy Ste A Orange Park FL 32003-4821
Phone: (904) 264-9555
Fax: (904) 215-7960
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X OS9412 Florida

Profile Details

NPI number 1376504662
LBN Legal business name Edelenbos, Eric J.
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2006
Last updated Jun 23rd, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376504662 NPPES
Florida MEDICAID 273408700

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