Edwards, Johnathan J
Edwards, Johnathan J is an sole proprietor health care provider with primary practice located at 301 Memorial Medical Pkwy , Daytona Beach FL 32117-5167. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Edwards, Johnathan J can be contacted via phone (386) 231-3072.Contact Information
Primary practice address
301 Memorial Medical Pkwy
Daytona Beach FL 32117-5167
Phone: (386) 231-3072
Fax: (386) 231-5962
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 10500 | Nevada |
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | ME119864 | Florida |
Profile Details
| NPI number | 1740258300 |
|---|---|
| LBN Legal business name | Edwards, Johnathan J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 9th, 2006 |
| Last updated | Mar 27th, 2019 - about 5 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740258300 | NPPES |
| Nevada | MEDICAID | 100504572 |
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