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Individual

MR. CORY MICAL EDGAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
2415 N ORANGE AVE STE 601, ORLANDO, FL 32804-5558
(407) 303-2070
(407) 303-2071
Mailing address
2415 N ORANGE AVE STE 601, ORLANDO, FL 32804-5558
(407) 303-2070
(407) 303-2071

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA09629
TX
363AM0700X
Medical Physician Assistant
Primary
PA9109621
FL
363AM0700X
Medical Physician Assistant
TX

Other

Enumeration date
01/20/2015
Last updated
09/14/2016
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