Individual
MR. WENDY PHREUD EDMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AC-AGNP
Contact information
Practice address
9299 SW 152ND ST STE 203, PALMETTO BAY, FL 33157-1776
(305) 322-4166
Mailing address
3178 STIRLING RD UNIT J7, HOLLYWOOD, FL 33021-2058
(786) 290-3485
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
64577
NM
363LA2100X
Acute Care Nurse Practitioner
73900
ID
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN9336037
FL
363LG0600X
Gerontology Nurse Practitioner
71013924A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023103400
—
FL
01
—
267030310
MEDICARE PTAN
IN
05
—
300076966
—
IN
01
—
OD206
MEDICARE HF
FL
Enumeration date
03/16/2017
Last updated
07/08/2025
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