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Organization
STACY EDWARDS, INC
Active
Organization
STACY EDWARDS, INC
Active
Other names
STACY L. EDWARDS, D.O.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STACY L EDWARDS DO (PHYSICIAN)
(727) 410-6655
Entity
Organization
Contact information
Practice address
2623 MCCORMICK DR STE 101, CLEARWATER, FL 33759-1046
(727) 564-9336
(727) 223-3228
Mailing address
1022 MAIN ST, SUITE M, DUNEDIN, FL 34698-5225
(727) 733-7922
(737) 738-6205
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS7714
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001713
UHC
FL
01
—
0161979008
CIGNA
FL
01
—
0412595
UHC
FL
01
—
1057441
AETNA
FL
01
—
123421
HUMANA
FL
01
—
1320
BAYCARE
FL
01
—
20886
BCBS
FL
01
—
257297
AVMED
FL
01
—
5580758
AETNA
FL
Enumeration date
07/15/2006
Last updated
10/29/2024
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