Organization
GERICARES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JIMMY EDMOND M.D. (OWNER)
(352) 666-0790
Entity
Organization
Contact information
Practice address
5344 SPRING HILL DR, SPRING HILL, FL 34606-4562
(352) 666-0790
(352) 666-0903
Mailing address
5344 SPRING HILL DR, SPRING HILL, FL 34606-4562
(352) 666-0790
(352) 666-0903
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
ME81127
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00780
UNIVERSAL ID
FL
01
—
06055
BLUE CROSS BLUE SHIELD ID
FL
01
—
123192
HUMANA ID
FL
01
—
125028
HUMANA GOLD PLUS ID
FL
01
—
1988649
UNITED HEALTHCARE ID
FL
01
—
241506
WELLCARE ID
FL
05
—
2795817 00
—
FL
01
—
28922
AVMED ID
FL
01
—
352728686
TRICARE ID
FL
01
—
5589903
FIRST HEALTH
FL
01
—
7128124
AETNA ID
FL
01
—
7572308
CIGNA ID
LA
01
—
ME81127
MEDICAL LICENSE NUMBER
FL
Enumeration date
01/25/2007
Last updated
10/31/2007
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