Individual
DR. MARY-ELLEN ADELE EDMISTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
331 S FLORIDA AVE STE 201, LAKELAND, FL 33801-4626
(863) 329-2750
Mailing address
331 S FLORIDA AVE STE 201, LAKELAND, FL 33801-4626
(863) 329-2750
Taxonomy
Speciality
Code
Description
License number
State
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
5916
TN
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
OS16990
FL
Other
Enumeration date
04/07/2014
Last updated
05/05/2026
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