Individual
EDWARD W ST. MARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
205 E NASA BLVD, MELBOURNE, FL 32901-1950
(321) 361-5625
(321) 728-8649
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 361-5625
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME53713
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013473400
—
FL
01
—
07142
BCBS
FL
01
—
200037430
RR MEDICARE
FL
Enumeration date
12/13/2005
Last updated
03/19/2020
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