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Individual

MS. BESSIE DENIESE EDWARDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
EDS

Contact information

Practice address
17434 NE 18TH AVE, CITRA, FL 32113-0505
(352) 595-2542
Mailing address
PO BOX 505, 17434 NE 18TH AVENUE, CITRA, FL 32113-0505
(352) 595-2542

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
763190100
FL
Enumeration date
05/13/2008
Last updated
05/13/2008
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