| Neil H Edison Md Pa | |
|
3107 Stirling Road Suite 103 Fort Lauderdale FL 33312-8500 | |
| (954) 986-1179 | |
| (954) 986-1959 |
| Full Name | Neil H Edison Md Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3107 Stirling Road, Fort Lauderdale, Florida |
| Authorized Official Name and Position | Neil Harvey Edison (PRESIDENT) |
| Authorized Official Contact | 9549861179 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neil H Edison Md Pa 3107 Stirling Road Suite 103 Fort Lauderdale FL 33312-8500 Ph: (954) 986-1179 | Neil H Edison Md Pa 3107 Stirling Road Suite 103 Fort Lauderdale FL 33312-8500 Ph: (954) 986-1179 |
| NPI Number | 1710055470 |
|---|---|
| Provider Enumeration Date | 12/01/2006 |
| Last Update Date | 06/23/2011 |
| Medicare PECOS PAC ID | 1951587740 |
|---|---|
| Medicare Enrollment ID | O20110511000745 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710055470 | NPI | - | NPPES |
| 003844 | Other | FL | AVMED |
| 058304900 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | ME0015827 (Florida) | Primary |
| Provider Name | Neil H Edison |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952599102 PECOS PAC ID: 1850577644 Enrollment ID: I20110531000138 |
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