Organization
DYNAMIC TOTAL HEALTH, L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC EDGERTON D.C. (OWNER)
(727) 286-6203
Entity
Organization
Contact information
Practice address
3444 E LAKE RD, SUITE 412, PALM HARBOR, FL 34685-2407
(727) 286-6203
(727) 286-6204
Mailing address
29901 US HIGHWAY 19 N, CLEARWATER, FL 33761-1041
(727) 286-6203
(727) 286-6204
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH10333
FL
111N00000X
Chiropractor
—
FL
207Q00000X
Family Medicine Physician
ME36242
FL
207Q00000X
Family Medicine Physician
ME79221
FL
207Q00000X
Family Medicine Physician
OS5939
FL
363L00000X
Nurse Practitioner
ARNP3356552
FL
363L00000X
Nurse Practitioner
ARNP9266947
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220HD
BCBS
FL
Enumeration date
01/31/2012
Last updated
11/07/2013
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