Individual
ADRIA L EDENFIELD II
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
11701-32 SAN JOSE BLVD #103, JACKSONVILLE, FL 32223
(904) 940-1441
Mailing address
11701-32 SAN JOSE BLVD #103, JACKSONVILLE, FL 32223
(904) 940-1441
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
PA3480
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292259200
—
FL
01
—
970009777
RAILROAD MEDICARE
FL
Enumeration date
06/15/2006
Last updated
12/12/2013
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